| Bay Ridge Dental Group, P.c. | |
|
8415 4th Ave A-16 Brooklyn NY 11209-4654 | |
| (718) 836-1716 | |
| (718) 836-3642 |
| Full Name | Bay Ridge Dental Group, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8415 4th Ave, Brooklyn, New York |
| Authorized Official Name and Position | Vera Pavlova (PARTNER) |
| Authorized Official Contact | 7188361716 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Ridge Dental Group, P.c. 8415 4th Ave A-16 Brooklyn NY 11209-4654 Ph: (718) 836-1716 | Bay Ridge Dental Group, P.c. 8415 4th Ave A-16 Brooklyn NY 11209-4654 Ph: (718) 836-1716 |
| NPI Number | 1164564274 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164564274 | NPI | - | NPPES |
| 02757913 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 049515 (New York) | Primary |
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