Organization
HOLLY DENTAL SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAM MINH PHAN (OWNER)
(718) 359-3113
Entity
Organization
Contact information
Practice address
14015 HOLLY AVE, GROUND FLOOR, FLUSHING, NY 11355-3433
(718) 359-3113
(718) 321-1478
Mailing address
14015 HOLLY AVE, GROUND FLOOR, FLUSHING, NY 11355-3433
(718) 359-3113
(718) 321-1478
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0581811
NY
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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