Guardian Dental PLLC
Dentist, General Practice in New York, NY. Organization (NPI-2).
NPI number1982124798
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1982124798
- Entity type
- Organization (NPI-2)
- Legal business name
- Guardian Dental PLLC
- Organization subpart
- No
- Enumeration date
- Jun 22, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 50-055536 | NY | Yes |
Practice location
3682 Broadway Frnt 1New York, NY 10031-1526
Phone 917-524-5622
Mailing address
3682 Broadway Frnt 1New York, NY 10031-1526
Phone 917-524-5622
Authorized official
Jeremy Yoo
President
9175245622
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