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General NPI Number Information
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NPI Number | 1144573254
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Entity Type | Organization
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Legal Business Name | SANFORD DENTAL P.C.
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Dates
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Enumeration Date | 10/26/2012
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 140-20 SANFORD AVE UNIT # 1B
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City | FLUSHING
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State | NY
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Zip | 11355
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Country | US
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Telephone | 917-376-2095
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Fax |
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Provider Business Mailing Address
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Address Line | 149 HESTER STREET SUITE 201
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City | NEW YORK
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State | NY
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Zip | 10002-4916
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Country | US
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Telephone | 917-376-2095
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HUA B. LEI
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Credential | DDS
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Telephone | 917-376-2095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 048813
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License Number State | NY
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