MEDICARE: STEINWAY FAMILY DENTAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1619198249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEINWAY FAMILY DENTAL CENTER

Provider Business Mailing Address
First Line	:	3234 STEINWAY ST
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11103-4006
Country	:	US
Telephone Number	:	718-728-3314
Fax Number	:

Provider Business Practice Location Address
First Line	:	3234 STEINWAY ST
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11103-4006
Country	:	US
Telephone Number	:	718-728-3314
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ANNIE OLSEN
Credential	:
Telephone Number	:	718-626-1050

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	08/22/2020

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