Organization · NPI-2

18th Ave Professional Dental PC

Dentist · Brooklyn, NY

NPI number1154593150
StatusActive
Last updated in NPPESOct 12, 2017

Details

NPI
1154593150
Entity type
Organization (NPI-2)
Legal business name
18th Ave Professional Dental PC
Organization subpart
No
Enumeration date
Mar 31, 2008
Last updated
Oct 12, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist049610NYYes

Practice location

2171 68th St Fl 3
Brooklyn, NY 11204-4733

Phone 347-713-1828 · Fax 347-713-1878

Mailing address

2171 68th St Fl 3
Brooklyn, NY 11204-4733

Phone 347-713-1828 · Fax 347-713-1878

Authorized official

Kenny H Ho
DDS/Owner
3477131828

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