Organization
MOHAMMED SHAHABUDDIN DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED SHAHABUDDIN D.D.S. (OWNER)
(718) 361-8677
Entity
Organization
Contact information
Practice address
3004 36TH AVE, LONG ISLAND CITY, NY 11106-2315
(718) 361-8677
(718) 361-0278
Mailing address
3004 36TH AVE, LONG ISLAND CITY, NY 11106-2315
(718) 361-8677
(718) 361-0278
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
042617
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01172485
—
NY
Enumeration date
01/17/2008
Last updated
04/26/2012
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