Knickerbocker Family Dental Center PC
Dentist in Brooklyn, NY. Organization (NPI-2).
NPI number1861521262
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1861521262
- Entity type
- Organization (NPI-2)
- Legal business name
- Knickerbocker Family Dental Center PC
- Organization subpart
- No
- Enumeration date
- Mar 4, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 039714 | NY | Yes |
Practice location
214 Stanhope StBrooklyn, NY 11237-4202
Phone 718-574-0527 · Fax 718-715-0624
Mailing address
214 Stanhope StBrooklyn, NY 11237-4202
Phone 718-574-0527 · Fax 718-715-0624
Authorized official
Larry D Jacobs
Chief Operating Officer
7185740527
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