Organization
LARISSA DAVIDS, D.D.S.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARISSA DAVIDS (PRESIDENT/ORTHODONTIST)
(718) 275-2006
Entity
Organization
Contact information
Practice address
98-41 QUEENS BOULVARD, APT # 1A, REGO PARK, NY 11374
(718) 275-2006
Mailing address
98-41 QUEENS BOULVARD, APT # 1A, REGO PARK, NY 11374
(718) 275-2006
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
048329
NY
Other
Enumeration date
07/16/2008
Last updated
07/16/2008
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