# PARK AVENUE DENTAL ANESTHESIA SERVICES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154741049
- **Authorized official:** DR. GREGORY C CHOTKOWSKI DMD (OWNER)
- **Authorized official phone:** (212) 838-0090

## Contact information

- **Practice address:** 563 PARK AVE, NEW YORK, NY 10065-7379
- **Practice address phone:** (212) 808-0090
- **Practice address fax:** (212) 935-1296
- **Mailing address:** 563 PARK AVE, NEW YORK, NY 10065-7379
- **Mailing address phone:** (212) 808-0090
- **Mailing address fax:** (212) 935-1296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 0417231 | NY | Yes |

## Other

- **Enumeration date:** 04/18/2014
- **Last updated:** 04/18/2014