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General NPI Number Information
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NPI Number | 1982910287
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Entity Type | Organization
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Legal Business Name | LITTLE NECK COME DENTAL
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 248-12 NORTHERN BOULEVARD SUITE 2F & 2G
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City | LITTLE NECK
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State | NY
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Zip | 11362
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Country | US
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Telephone | 917-657-3934
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Fax |
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Provider Business Mailing Address
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Address Line | 248-12 NORTHERN BLVD SUITE 2F & 2G
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City | LITTLE NECK
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State | NY
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Zip | 11362
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Country | US
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Telephone | 917-657-3934
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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. DAVID CHOI
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Credential | D.D.S.
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Telephone | 917-657-3934
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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 | 50054937
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License Number State | NY
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