Organization
KIDS DENTAL STUDIO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEN CHU DDS (PRESIDENT)
(917) 607-1028
Entity
Organization
Contact information
Practice address
21154 45TH DR, 2ND FLOOR, BAYSIDE, NY 11361-3310
(718) 428-3300
Mailing address
19669 45TH DR, FLUSHING, NY 11358-3509
(718) 631-5515
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
047519
NY
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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