Organization
ASTORIA GENERAL DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WANDA E MEJIA DDS (OWNER)
(718) 545-7046
Entity
Organization
Contact information
Practice address
3018 31ST AVE, ASTORIA, NY 11106-2405
(718) 545-7046
(715) 545-2606
Mailing address
3018 31ST AVE, ASTORIA, NY 11106-2405
(718) 545-7046
(715) 545-2606
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
048615
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
NY
05
—
02166109
—
NY
Enumeration date
05/30/2007
Last updated
08/22/2020
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