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General NPI Number Information
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NPI Number | 1669030342
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Entity Type | Organization
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Legal Business Name | HILLCREST DENTAL ASSOCIATE, P.C.
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 18011 UNION TPKE
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City | FLUSHING
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State | NY
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Zip | 11366-1619
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Country | US
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Telephone | 347-688-9940
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Fax |
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Provider Business Mailing Address
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Address Line | 18011 UNION TPKE
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City | FLUSHING
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State | NY
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Zip | 11366-1619
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TOBY COHEN
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Credential |
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Telephone | 347-688-9940
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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 |
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License Number State |
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