MEDICARE: NEW TODAY'S DENTAL

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	052609	NY

General Provider Information

NPI Number	:	1801129036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW TODAY'S DENTAL

Provider Business Mailing Address
First Line	:	3411 STEINWAY ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-1319
Country	:	US
Telephone Number	:	718-392-1888
Fax Number	:	718-392-6979

Provider Business Practice Location Address
First Line	:	3411 STEINWAY ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-1319
Country	:	US
Telephone Number	:	718-392-1888
Fax Number	:	718-392-6979

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SUKCHAN AHN
Credential	:	D.D.S.
Telephone Number	:	718-392-1888

Provider Enumeration Date	:	09/04/2009
Last Update Date	:	09/04/2009

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Directions to “NEW TODAY'S DENTAL ” Practice Location

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