# EAST 4TH STREET DENTAL PLLC

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

## Provider details

- **NPI number:** 1205490182
- **Authorized official:** DR. DMITRIY VOLOTSENKO DDS (MANAGING MEMBER)
- **Authorized official phone:** (917) 797-8052

## Contact information

- **Practice address:** 101 EAST 4TH STREET, NEW YORK, NY 10003
- **Practice address phone:** (212) 239-7027
- **Mailing address:** 101 EAST 4TH STREET, NEW YORK, NY 10003
- **Mailing address phone:** (212) 239-7027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/26/2019
- **Last updated:** 04/26/2019