Organization
INTO WHITE DENTAL ARTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN KONSTANTINE MANTINAOS D.D.S. (OWNER/DENTIST-PROSTHODONTIST)
(718) 361-3050
Entity
Organization
Contact information
Practice address
4743 VERNON BLVD, GROUND FLOOR, LONG ISLAND CITY, NY 11101-5519
(718) 361-3050
Mailing address
4743 VERNON BLVD, GROUND FLOOR, LONG ISLAND CITY, NY 11101-5519
(718) 361-3050
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5067165
NY
Other
Enumeration date
12/16/2008
Last updated
11/05/2011
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