| Boss Dental | |
|
821 57th Street, 1st Fl Brooklyn NY 11220-3645 | |
| (718) 686-0313 | |
| Not Available |
| Full Name | Boss Dental |
|---|---|
| Speciality | Dentist |
| Location | 821 57th Street, 1st Fl, Brooklyn, New York |
| Authorized Official Name and Position | Angela Lo (MANAGER) |
| Authorized Official Contact | 7188867222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boss Dental 821 57th Street, 1st Fl Brooklyn NY 11220-3645 Ph: () - | Boss Dental 821 57th Street, 1st Fl Brooklyn NY 11220-3645 Ph: (718) 686-0313 |
| NPI Number | 1982843785 |
|---|---|
| Provider Enumeration Date | 02/18/2009 |
| Last Update Date | 02/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982843785 | NPI | - | NPPES |
| 02618188 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 047068 (New York) | Primary |
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