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General NPI Number Information
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NPI Number | 1376351668
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Entity Type | Organization
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Legal Business Name | LEPRECHAUN DENTAL P.C.
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 01/05/2025
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Provider Practice Location Address
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Address Line | 976 BARD AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3322
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Country | US
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Telephone | 718-448-1866
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Fax | 718-448-9492
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Provider Business Mailing Address
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Address Line | 976 BARD AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3322
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Country | US
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Telephone | 718-448-1866
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Fax | 718-448-9492
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID FLYNN
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Credential | DDS
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Telephone | 917-880-8242
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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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