| Specialty Dental Of Greenpoint, P.c. | |
|
92 Norman Ave Brooklyn NY 11222-2934 | |
| (718) 383-0933 | |
| (718) 349-0930 |
| Full Name | Specialty Dental Of Greenpoint, P.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 92 Norman Ave, Brooklyn, New York |
| Authorized Official Name and Position | Charles J Ptak (PRESIDENT) |
| Authorized Official Contact | 7183830933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Dental Of Greenpoint, P.c. 92 Norman Ave Brooklyn NY 11222-2934 Ph: (718) 383-0933 | Specialty Dental Of Greenpoint, P.c. 92 Norman Ave Brooklyn NY 11222-2934 Ph: (718) 383-0933 |
| NPI Number | 1750434809 |
|---|---|
| Provider Enumeration Date | 01/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750434809 | NPI | - | NPPES |
| 00782729 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 0522391 (New York) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 034744 (New York) | Primary |
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