Provider Demographics
NPI:1831486067
Name:NORA FAMILY DENTA
Entity Type:Organization
Organization Name:NORA FAMILY DENTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUNESSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-657-0000
Mailing Address - Street 1:18241 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2329
Mailing Address - Country:US
Mailing Address - Phone:718-657-0000
Mailing Address - Fax:718-657-0000
Practice Address - Street 1:18241 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2329
Practice Address - Country:US
Practice Address - Phone:718-657-0000
Practice Address - Fax:718-657-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049216122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty