Organization · NPI-2

2090 Dental PC

Dentist, General Practice · New York, NY

NPI number1891185245
StatusActive
Last updated in NPPESJan 23, 2015

Details

NPI
1891185245
Entity type
Organization (NPI-2)
Legal business name
2090 Dental PC
Organization subpart
No
Enumeration date
Jan 23, 2015
Last updated
Jan 23, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice––Yes
1223S0112X Dentist, Oral and Maxillofacial Surgery––
124Q00000X Dental Hygienist––

Practice location

2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990

Phone 212-749-2222 · Fax 212-749-2220

Mailing address

2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990

Phone 212-749-2222 · Fax 212-749-2220

Authorized official

Paul P Symeonides
President
9176970845

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