Organization
TCN DENTAL CARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD SHALOMOV DDS (DENTIST/PRESIDENT)
(718) 523-8400
Entity
Organization
Contact information
Practice address
16110 JAMAICA AVE, SUITE 313, JAMAICA, NY 11432-6149
(718) 523-8400
(718) 523-0565
Mailing address
16110 JAMAICA AVE, SUITE 313, JAMAICA, NY 11432-6149
(718) 523-8400
(718) 523-0565
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
054092
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699921437
—
NY
Enumeration date
12/06/2010
Last updated
12/06/2010
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