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General NPI Number Information
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NPI Number | 1700410974
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Entity Type | Organization
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Legal Business Name | PAPPAS PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 21541 23RD RD
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City | BAYSIDE
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State | NY
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Zip | 11360-2227
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Country | US
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Telephone | 718-224-0443
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Fax |
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Provider Business Mailing Address
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Address Line | 21541 23RD RD
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City | BAYSIDE
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State | NY
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Zip | 11360-2227
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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 | OWNER/PARTNER
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Name | DESPINA PAPPAS
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Credential | DDS
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Telephone | 718-344-6028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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