| New York University College Of Dentistry | |
|
345 E 24th St New York NY 10010-4020 | |
| (212) 998-9879 | |
| (212) 995-4851 |
| Full Name | New York University College Of Dentistry |
|---|---|
| Speciality | Clinic/Center |
| Location | 345 E 24th St, New York, New York |
| Authorized Official Name and Position | Michael P. O'connor (EXEC. ASSOC. DEAN FOR ADMIN FINANCE) |
| Authorized Official Contact | 2129989930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New York University College Of Dentistry 345 E 24th St New York NY 10010-4020 Ph: (212) 998-9879 | New York University College Of Dentistry 345 E 24th St New York NY 10010-4020 Ph: (212) 998-9879 |
| NPI Number | 1164555124 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 10/03/2018 |
| Medicare PECOS PAC ID | 1355232422 |
|---|---|
| Medicare Enrollment ID | O20180924000969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164555124 | NPI | - | NPPES |
| 01334674 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 021314-2 (New York) | Primary |
| Provider Name | Robert Glickman |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1104915230 PECOS PAC ID: 8123286457 Enrollment ID: I20120216000060 |
| Provider Name | Denise A Trochesset |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841253788 PECOS PAC ID: 6608026679 Enrollment ID: I20121029000376 |
| Provider Name | Jessica Hilburg |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1013049097 PECOS PAC ID: 4486954740 Enrollment ID: I20180924001150 |
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