Provider Demographics
NPI:1417237280
Name:RICHMOND HILL DENTAL ARTS PLLC
Entity Type:Organization
Organization Name:RICHMOND HILL DENTAL ARTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEVID
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-494-2010
Mailing Address - Street 1:255 RICHMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5906
Mailing Address - Country:US
Mailing Address - Phone:718-494-2010
Mailing Address - Fax:718-761-4743
Practice Address - Street 1:255 RICHMOND HILL RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5906
Practice Address - Country:US
Practice Address - Phone:718-494-2010
Practice Address - Fax:718-761-4743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035401122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty