Organization
CORRECTIONAL DENTAL ASSOCIATES OF NEW YORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE AMBROSE HAYLING JR. D.D.S. (PRESIDENT)
(347) 774-7800
Entity
Organization
Contact information
Practice address
4904 19TH AVE, ASTORIA, NY 11105-1002
(347) 774-7800
(718) 777-7820
Mailing address
4904 19TH AVE, ASTORIA, NY 11105-1002
(347) 774-7800
(718) 777-7820
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
051827-1
NY
Other
Enumeration date
04/26/2013
Last updated
04/26/2013
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