Marine Dental Services

LBN: Jack Miceli Dds Pc
Marine Dental Services is an health care organization with primary practice located at 255 Mason Ave. , Staten Island NY 10305-3416. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Jack Miceli Dds Pc can be contacted via phone (718) 987-6543, or through Miceli, Jack via phone (718) 987-6543.

Contact Information

Primary practice address
255 Mason Ave. Staten Island NY 10305-3416
Phone: (718) 987-6543
Fax: (718) 987-6542
Website:
Map and Directions
Authorized official contact:
Name: Miceli, Jack Doctor of Dental Surgery (DDS)
Phone: (718) 987-6543

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 39067 New York

Profile Details

NPI number 1932266566
LBN Legal business name Jack Miceli Dds Pc
DBA Doing business as Marine Dental Services
Authorized official Miceli, Jack Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Feb 23rd, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932266566 NPPES
New York MEDICAID 02353280

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