Organization
UPPER DITMARS DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARISTOTLE LYSSIKATOS DDS (OWNER)
(908) 705-7122
Entity
Organization
Contact information
Practice address
2128 80TH ST, EAST ELMHURST, NY 11370-1323
(908) 705-7122
Mailing address
2128 80TH ST, EAST ELMHURST, NY 11370-1323
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
052126
NY
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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