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Organization
PARK WEST DENTAL PC
Active
Organization
PARK WEST DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME S LUSTBADER DMD (PRESIDENT)
(212) 757-1370
Entity
Organization
Contact information
Practice address
200 CENTRAL PARK S, SUITE 102, NEW YORK, NY 10019-1436
(212) 757-1370
(212) 757-2819
Mailing address
200 CENTRAL PARK S, SUITE 102, NEW YORK, NY 10019-1436
(212) 757-1370
(212) 757-2819
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
033896
NY
Other
Enumeration date
05/10/2007
Last updated
08/22/2020
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