DIVINE DENTAL PC NPI 1235454208

NPI Information

DIVINE DENTAL PC is a general practice dentist in Flushing, NY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DIVINE DENTAL PC NPI is 1235454208. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4125 KISSENA BLVD STE 101
FLUSHING, NY
ZIP 11355-153
Phone: (718) 353-2312
Fax: (718) 321-7120

The provider's authorized official is Kevin Seokkyu Lee .
The authorized official title is Dentist/owner and has the following contact phone number (718) 353-2312.

The enumeration date for this NPI number is 4/2/2010 and was last updated on 4/2/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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