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Organization
NINTH AVENUE DENTAL P.C.
Active
Organization
NINTH AVENUE DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J WEISS DDS (PRESIDENT)
(718) 435-6858
Entity
Organization
Contact information
Practice address
4109 9TH AVE, BROOKLYN, NY 11232-4001
(718) 435-6858
(718) 435-5017
Mailing address
4109 9TH AVE, BROOKLYN, NY 11232-4001
(718) 435-6858
(718) 435-5017
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
037498-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00823116
—
NY
Enumeration date
07/05/2007
Last updated
06/20/2008
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