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General NPI Number Information
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NPI Number | 1558702092
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Entity Type | Organization
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Legal Business Name | ASH ESTAFAN DDS P.C.
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 14 VANDERVENTER AVE STE 215
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3777
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Country | US
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Telephone | 516-883-6199
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Fax |
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Provider Business Mailing Address
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Address Line | 14 VANDERVENTER AVE STE 215
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3777
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Country | US
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Telephone | 516-883-6199
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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. ASHRAF M ESTAFAN
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Credential | DDS
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Telephone | 516-883-6199
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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 | 049384
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License Number State | NY
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