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General NPI Number Information
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NPI Number | 1013725407
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Entity Type | Organization
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Legal Business Name | ARIZA DENTAL CARE, PLLC
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 8639 WOODHAVEN BLVD
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City | JAMAICA
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State | NY
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Zip | 11421-1438
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Country | US
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Telephone | 718-845-7772
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Fax |
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Provider Business Mailing Address
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Address Line | 8555 106TH ST
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City | RICHMOND HILL
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State | NY
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Zip | 11418-1130
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHARLES K ARIZA
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Credential | DDS
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Telephone | 646-392-6883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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