Mark R. Herzog, D.d.s., P.c. | |
8421 Bay Pkwy Brooklyn NY 11214-3303 | |
(718) 259-1110 | |
(718) 259-1198 |
Full Name | Mark R. Herzog, D.d.s., P.c. |
---|---|
Speciality | Dentist |
Location | 8421 Bay Pkwy, Brooklyn, New York |
Authorized Official Name and Position | Mark R. Herzog (PRESIDENT) |
Authorized Official Contact | 7182591110 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mark R. Herzog, D.d.s., P.c. 8421 Bay Pkwy Brooklyn NY 11214-3303 Ph: (718) 259-1110 | Mark R. Herzog, D.d.s., P.c. 8421 Bay Pkwy Brooklyn NY 11214-3303 Ph: (718) 259-1110 |
NPI Number | 1639371511 |
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Provider Enumeration Date | 06/04/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639371511 | NPI | - | NPPES |
01200797 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 038484 (New York) | Primary |
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