Provider Demographics
NPI:1871315630
Name:NY COMMUNITY DENTAL PC
Entity type:Organization
Organization Name:NY COMMUNITY DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:R
Authorized Official - Last Name:ASURZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:912-572-1108
Mailing Address - Street 1:2001 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1635
Mailing Address - Country:US
Mailing Address - Phone:718-721-5796
Mailing Address - Fax:
Practice Address - Street 1:2001 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1635
Practice Address - Country:US
Practice Address - Phone:718-721-5796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental