Organization
AL-SHIFA DENTAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED MANSOORUL IMAM DDS (PRESIDENT)
(718) 434-5678
Entity
Organization
Contact information
Practice address
1129 CONEY ISLAND AVE, BROOKLYN, NY 11230-2358
(718) 434-5678
(718) 744-0482
Mailing address
1129 CONEY ISLAND AVE, BROOKLYN, NY 11230-2358
(718) 434-5678
(718) 744-0482
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049149
NY
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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