| 2nd Avenue Tooth Doctor,pc | |
|
1976 2nd Ave New York NY 10029 | |
| (212) 996-6269 | |
| Not Available |
| Full Name | 2nd Avenue Tooth Doctor,pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1976 2nd Ave, New York, New York |
| Authorized Official Name and Position | Gina Colon (OFFICE MANAGER) |
| Authorized Official Contact | 2129966269 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 2nd Avenue Tooth Doctor,pc 1976 2nd Ave New York NY 10029 Ph: (212) 996-6269 | 2nd Avenue Tooth Doctor,pc 1976 2nd Ave New York NY 10029 Ph: (212) 996-6269 |
| NPI Number | 1538378633 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538378633 | NPI | - | NPPES |
| 02783984 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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