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Organization
PARK AVENUE PERIODONTAL PROSTHESIS OBS FACILITY
Active
Organization
PARK AVENUE PERIODONTAL PROSTHESIS OBS FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PASQUALE J MALPESO D.M.D. (OWNER)
(212) 838-0090
Entity
Organization
Contact information
Practice address
563 PARK AVE, NEW YORK, NY 10065-7314
(212) 838-0090
(212) 935-1296
Mailing address
563 PARK AVE, NEW YORK, NY 10065-7314
(212) 838-0090
(212) 935-1296
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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