Organization
ARDEN DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERY DUBOVIKOV DDS (DDS/OWNER)
(718) 948-0870
Entity
Organization
Contact information
Practice address
337 HAMPTON GREEN, STATEN ISLAND, NY 10312-0000
(718) 948-0870
Mailing address
337 HAMPTON GREEN, STATEN ISLAND, NY 10312-0000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02355737
—
NY
Enumeration date
10/15/2009
Last updated
09/25/2013
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