Corona 26 Dental Group

NPI #1245632207 in Corona, New York

Provider Information

NPI Number: 1245632207
Entity Type: Organization
Organization Name: Corona 26 Dental Group
Primary Specialty: Dentist
Enumeration Date: Sep 22, 2014
Last Updated: Sep 22, 2014

Practice Location

Address: 10308 ROOSEVELT AVE
Address 2: 2ND FLOOR
City: Corona
State: New York
ZIP Code: 11368-2330
Phone: (718) 397-7000

Authorized Official

Name: ALICIA A PITKOUVICH
Title: MANAGER
Phone: (917) 391-8000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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