# WESTSIDE DENTIST, P.C.

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

## Provider details

- **NPI number:** 1346640190
- **Authorized official:** DR. ANNA BARANTSEVICH (PRESIDENT)
- **Authorized official phone:** (212) 247-5050

## Contact information

- **Practice address:** 57 W 58TH ST, SUITE 2C, NEW YORK, NY 10019-1630
- **Practice address phone:** (212) 247-5050
- **Practice address fax:** (212) 581-3596
- **Mailing address:** 57 W 58TH ST, SUITE 2C, NEW YORK, NY 10019-1630
- **Mailing address phone:** (212) 247-5050
- **Mailing address fax:** (212) 581-3596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 046914 | NY | Yes |

## Other

- **Enumeration date:** 08/29/2014
- **Last updated:** 08/29/2014