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General NPI Number Information
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NPI Number | 1184787061
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Entity Type | Organization
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Legal Business Name | TEODORA R CONSTANTINESCU DDS PC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 78 12 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-2900
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Country | US
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Telephone | 718-821-5573
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Fax | 718-381-3285
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Provider Business Mailing Address
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Address Line | 78 12 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-2900
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Country | US
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Telephone | 718-821-5573
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Fax | 718-381-3285
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TEODORA RODICA CONSTANTINESCU
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Credential | DDS
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Telephone | 718-821-5573
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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 | 033300
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License Number State | NY
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