Healthcare Provider Details

I. General information

NPI: 1679395784
Provider Name (Legal Business Name): ACE DENTAL CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

362 W OLD COUNTRY RD
HICKSVILLE NY
11801-4113
US

IV. Provider business mailing address

PO BOX 7
ROSLYN NY
11576-0007
US

V. Phone/Fax

Practice location:
  • Phone: 516-292-7376
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANET WILLIAMS
Title or Position: PRESIDENT
Credential: DDS, MPH
Phone: 516-292-7376