MEDICARE: DENTISTS DELIVERING SERVICES PLLC

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	261QD0000X	Dental Clinic/Center	32454	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831170752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTISTS DELIVERING SERVICES PLLC

Provider Business Mailing Address
First Line	:	22002 94TH DR
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11428-2106
Country	:	US
Telephone Number	:	917-545-1226
Fax Number	:

Provider Business Practice Location Address
First Line	:	22002 94TH DR
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11428-2106
Country	:	US
Telephone Number	:	917-545-1226
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DR. NORMAN H KLEIN
Credential	:	D.D.S.
Telephone Number	:	917-545-1226

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	12/23/2013

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