Organization
CITIDENTAL OF WOODHAVEN PC
Active
Other names
CitiDental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARINA SHRAGA DDS (PRESIDENT)
(917) 797-7272
Entity
Organization
Contact information
Practice address
10149 WOODHAVEN BLVD, SUITE 2, OZONE PARK, NY 11416-2300
(718) 848-7722
Mailing address
10149 WOODHAVEN BLVD, SUITE 2, OZONE PARK, NY 11416-2300
(718) 848-7722
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
052174
NY
122300000X
Dentist
055124
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02721117
—
NY
05
—
03307031
—
NY
Enumeration date
08/06/2011
Last updated
09/01/2011
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