Provider Demographics
NPI:1548716251
Name:DENTAL CARE OF ASTORIA PC
Entity type:Organization
Organization Name:DENTAL CARE OF ASTORIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISTIDOU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-278-8183
Mailing Address - Street 1:3601 31ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1015
Mailing Address - Country:US
Mailing Address - Phone:718-278-8183
Mailing Address - Fax:718-278-8188
Practice Address - Street 1:3601 31ST AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-1085
Practice Address - Country:US
Practice Address - Phone:718-278-8183
Practice Address - Fax:718-278-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038867305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03176616Medicaid