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General NPI Number Information
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NPI Number | 1487274445
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Entity Type | Organization
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Legal Business Name | ROCK A SMILE DENTAL STUDIO PLLC
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 9708 ROCKAWAY BLVD
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City | OZONE PARK
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State | NY
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Zip | 11417-1615
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Country | US
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Telephone | 178-360-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 9708 ROCKAWAY BLVD
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City | OZONE PARK
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State | NY
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Zip | 11417-1615
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Country | US
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Telephone | 178-360-1166
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RBEEA KHAN
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Credential | DDS
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Telephone | 646-643-7472
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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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