Provider Demographics
NPI:1225209315
Name:HAROLD MOSTEL,DDS,PC
Entity Type:Organization
Organization Name:HAROLD MOSTEL,DDS,PC
Other - Org Name:SMILE SAVERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-327-3506
Mailing Address - Street 1:238 BEACH 20TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3627
Mailing Address - Country:US
Mailing Address - Phone:718-327-3506
Mailing Address - Fax:516-239-0538
Practice Address - Street 1:238 BEACH 20TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3627
Practice Address - Country:US
Practice Address - Phone:718-327-3506
Practice Address - Fax:516-239-0538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043127122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01370790Medicaid