Organization
ASTORIA DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLIFFORD EDWARD DEGEL D.D.S. (PRESIDENT)
(718) 278-1123
Entity
Organization
Contact information
Practice address
3217 BROADWAY, ASTORIA, NY 11106-2674
(718) 278-1123
(718) 278-6048
Mailing address
3217 BROADWAY, ASTORIA, NY 11106-2674
(718) 278-1123
(718) 278-6048
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
042417
NY
1223G0001X
General Practice Dentistry
043236
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01215461
—
NY
05
—
01227738
—
NY
Enumeration date
04/12/2007
Last updated
02/03/2016
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