OrganizationEvydent Dentistry PcDentistDental ProvidersPractice Address29 Cooper St Apt 1a, New York, NY 10034-3819(212) 567-3368PECOS EnrollmentBased on the most recent information from CMS, provider Evydent Dentistry Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1841588613Provider TypeOrganizationFull NameEvydent Dentistry PcSubpartNoEnumeration Date7/14/2011Last Updated7/14/2011Contact InformationPractice LocationPractice Address29 Cooper St Apt 1a, New York, NY 10034-3819Phone(212) 567-3368Fax(212) 567-1941Mailing LocationMailing Address29 Cooper St Apt 1a, New York, NY 10034-3819Phone(212) 567-3368Fax(212) 567-1941Authorized OfficialNameMigadaki, Evanthia (President)Phone(212) 567-3368Provider TaxonomiesCodeDescriptionLicenseCode122300000XPrimaryDescriptionDentistDental ProvidersLicense053522New YorkProvider IdentifiersIDDescriptionIssuerID02735000DescriptionMedicaidIssuerUnlistedNew York