Organization
CRYSTAL DENTAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON LIN (DIRECTOR)
(718) 352-0220
Entity
Organization
Contact information
Practice address
38-50 BELL BLVD, SUITE E, BAYSIDE, NY 11361
(718) 352-0220
Mailing address
38-50 BELL BLVD, SUITE E, BAYSIDE, NY 11361
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
051269
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04347664
—
NY
Enumeration date
05/05/2016
Last updated
05/05/2016
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