Organization
BLUESTAR DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R DAGOSTINO DDS (DIRECTOR OF DENTAL AND ORAL MED)
(718) 209-8500
Entity
Organization
Contact information
Practice address
2110 ROCKAWAY PKWY, BROOKLYN, NY 11236-5802
(718) 209-8500
(718) 942-4582
Mailing address
2110 ROCKAWAY PKWY, BROOKLYN, NY 11236-5802
(718) 209-8500
(718) 942-4582
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
049803-1
NY
122300000X
Dentist
Primary
049832-1
NY
1223P0700X
Prosthodontics
047926-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02769157
—
NY
Enumeration date
11/30/2006
Last updated
03/20/2008
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