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General NPI Number Information
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NPI Number | 1699923540
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Entity Type | Organization
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Legal Business Name | DHAKA DENTAL PC
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 40-14 GREENPOINT AVE
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City | SUNNYSIDE
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State | NY
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Zip | 11104
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Country | US
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Telephone | 718-392-2858
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Fax |
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Provider Business Mailing Address
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Address Line | 170-09 HILLSIDE AVE
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City | JAMICA
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State | NY
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Zip | 11423
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Country | US
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Telephone | 718-291-2710
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. MAHFUJUL HASAN
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Credential | DDS
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Telephone | 718-329-3110
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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 | 044293
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License Number State | NY
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