Organization
77 DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOHAR K SHRESTHA DDS (PRESIDENT)
(718) 779-3324
Entity
Organization
Contact information
Practice address
37-40 77 STREET, 1ST FL, JACKSON HEIGHTS, NY 11372-6630
(718) 779-3324
(718) 779-3324
Mailing address
37-40 77 STREET, 1ST FL, JACKSON HEIGHTS, NY 11372-6630
(718) 779-3324
(718) 779-3324
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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