| Live Well Dental Services Pllc | |
|
86 Pierrepont St Brooklyn NY 11201-2819 | |
| (718) 875-8088 | |
| Not Available |
| Full Name | Live Well Dental Services Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 86 Pierrepont St, Brooklyn, New York |
| Authorized Official Name and Position | David Tavelin (SOLE MEMBER) |
| Authorized Official Contact | 9173093961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Well Dental Services Pllc 365 Bridge St Apt 3o Brooklyn NY 11201-3802 Ph: (917) 309-3961 | Live Well Dental Services Pllc 86 Pierrepont St Brooklyn NY 11201-2819 Ph: (718) 875-8088 |
| NPI Number | 1346790813 |
|---|---|
| Provider Enumeration Date | 10/09/2016 |
| Last Update Date | 10/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346790813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 50111243 (New York) | Primary |
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