Staten Island Mall Dental, P.c.
NPI #1013139237 in Staten Island, New York
Provider Information
- NPI Number
- 1013139237
- Entity Type
- Organization
- Organization Name
- Staten Island Mall Dental, P.c.
- Primary Specialty
- Dentist
- Enumeration Date
- May 3, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2655 RICHMOND AVENUE
- Address 2
- 2220
- City
- Staten Island
- State
- New York
- ZIP Code
- 10314
- Phone
- (718) 982-5500
Authorized Official
- Name
- ROSS KRASNOV, D.D.S.
- Title
- DENTIST
- Phone
- (718) 982-5500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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