# COLUMBUS PARK DENTAL

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

## Provider details

- **NPI number:** 1194506196
- **Authorized official:** ASHLEY FALLA (OPERATIONAL MANAGER)
- **Authorized official phone:** (917) 580-7360

## Contact information

- **Practice address:** 40 W 72ND ST STE B, NEW YORK, NY 10023-4195
- **Practice address phone:** (917) 580-7360
- **Practice address fax:** (917) 580-7334
- **Mailing address:** 40 W 72ND ST STE B, NEW YORK, NY 10023-4195
- **Mailing address phone:** (917) 580-7360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/06/2023
- **Last updated:** 10/06/2023