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General NPI Number Information
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NPI Number | 1962289231
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Entity Type | Organization
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Legal Business Name | GREEN GARDEN DENTAL PC
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 8809 NORTHERN BLVD
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-1626
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Country | US
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Telephone | 718-429-7744
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Fax | 718-429-7791
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Provider Business Mailing Address
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Address Line | 8809 NORTHERN BLVD
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-1626
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Country | US
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Telephone | 718-429-7744
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Fax | 718-429-7791
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAZHAR ALHADID
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Credential | DDS
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Telephone | 718-687-0014
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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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