Organization
AMES DENTAL.P.C
Active
Other names
Queens Central Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILYA MALE AMES D.D.S. (PRESIDENT)
(718) 309-2531
Entity
Organization
Contact information
Practice address
8306 NORTHERN BLVD, JACKSON HEIGHTS, NY 11372-1460
(718) 429-0440
Mailing address
8306 NORTHERN BLVD, JACKSON HEIGHTS, NY 11372-1460
(718) 429-0440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051675-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02615007
—
NY
Enumeration date
03/14/2017
Last updated
03/14/2017
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