| Gallery 57 Dental | |
|
24 W 57th St Suite 701 New York NY 10019-3918 | |
| (212) 246-8700 | |
| (212) 246-8707 |
| Full Name | Gallery 57 Dental |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 24 W 57th St, New York, New York |
| Authorized Official Name and Position | Mason Kostinsky (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 2122468700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gallery 57 Dental 24 W 57th St Suite 701 New York NY 10019-3918 Ph: (212) 246-8700 | Gallery 57 Dental 24 W 57th St Suite 701 New York NY 10019-3918 Ph: (212) 246-8700 |
| NPI Number | 1760763148 |
|---|---|
| Provider Enumeration Date | 08/30/2011 |
| Last Update Date | 08/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760763148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 033746 (New York) | Secondary |
| 1223P0700X | Dentist - Prosthodontics | 035303 (New York) | Primary |
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