Provider Demographics
NPI:1508379546
Name:C&O DENTAL,PLLC.
Entity Type:Organization
Organization Name:C&O DENTAL,PLLC.
Other - Org Name:WOODSIDE FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SECAREANU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-651-7700
Mailing Address - Street 1:5903 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3546
Mailing Address - Country:US
Mailing Address - Phone:718-651-7700
Mailing Address - Fax:718-429-6795
Practice Address - Street 1:5903 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3546
Practice Address - Country:US
Practice Address - Phone:718-651-7700
Practice Address - Fax:718-429-6795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental