2nd Avenue Tooth Doctor,pc
Dentist, General Practice in New York, NY. Organization (NPI-2).
NPI number1538378633
StatusActive
Last updated in NPPESJun 13, 2008
Details
- NPI
- 1538378633
- Entity type
- Organization (NPI-2)
- Legal business name
- 2nd Avenue Tooth Doctor,pc
- Organization subpart
- No
- Enumeration date
- May 22, 2007
- Last updated
- Jun 13, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
1976 2nd AveNew York, NY 10029
Phone 212-996-6269
Mailing address
1976 2nd AveNew York, NY 10029
Phone 212-996-6269
Authorized official
Gina Colon
Office Manager
2129966269
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