# LIVE WELL DENTAL SERVICES PLLC

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

## Provider details

- **NPI number:** 1346790813
- **Authorized official:** DR. DAVID TAVELIN DDS (SOLE MEMBER)
- **Authorized official phone:** (917) 309-3961

## Contact information

- **Practice address:** 86 PIERREPONT ST, BROOKLYN, NY 11201-2819
- **Practice address phone:** (718) 875-8088
- **Mailing address:** 365 BRIDGE ST APT 3O, BROOKLYN, NY 11201-3802
- **Mailing address phone:** (917) 309-3961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 50111243 | NY | Yes |

## Other

- **Enumeration date:** 10/09/2016
- **Last updated:** 10/09/2016