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General NPI Number Information
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NPI Number | 1720109390
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Entity Type | Organization
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Legal Business Name | MZIA KRIKHELY DDS PC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 111 17A QWEENS BLVD
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 718-544-2424
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Fax | 718-544-2428
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Provider Business Mailing Address
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Address Line | 111 17A QWEENS BLVD
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 718-544-2424
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Fax | 718-544-2428
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Authorized Official
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Title or Position | OWNER
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Name | DR. MZIA M KRIKHELY
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Credential | DDS
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Telephone | 718-544-2424
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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 | 041646
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License Number State | NY
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