Organization
ENDODONTIC ASSOCIATES OF BAYSIDE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY PANAGOPOULOS (OFFICE MANAGER)
(718) 224-4000
Entity
Organization
Contact information
Practice address
58-47 FRANCIS LEWIS BLVD, SUITE 12, BAYSIDE, NY 11364-1601
(718) 224-4000
(718) 224-1921
Mailing address
58-47 FRANCIS LEWIS BLVD, SUITE 12, BAYSIDE, NY 11364-1601
(718) 224-4000
(718) 224-1921
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
032322
NY
1223E0200X
Endodontics
047274
NY
Other
Enumeration date
09/24/2008
Last updated
09/24/2008
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