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Organization

EVAN P. MONDSHINE, D.D.S., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EVAN P MONDSHINE D.D.S. (OWNER)
(718) 268-1561
Entity
Organization

Contact information

Practice address
6836 108TH ST STE B10, FOREST HILLS, NY 11375-3366
(718) 268-1561
(718) 268-1577
Mailing address
6836 108TH ST STE B10, FOREST HILLS, NY 11375-3366
(718) 268-1561
(718) 268-1577

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
031513
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00339946
NY
Enumeration date
02/26/2007
Last updated
03/12/2012
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