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General NPI Number Information
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NPI Number | 1871315630
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Entity Type | Organization
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Legal Business Name | NY COMMUNITY DENTAL PC
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Dates
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Enumeration Date | 10/31/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 2001 STEINWAY ST
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City | ASTORIA
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State | NY
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Zip | 11105-1635
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Country | US
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Telephone | 718-721-5796
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 STEINWAY ST
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City | ASTORIA
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State | NY
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Zip | 11105-1635
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Country | US
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Telephone | 718-721-5796
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HUGO R ASURZA
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Credential | DDS
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Telephone | 912-572-1108
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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 |
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License Number State |
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