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Organization
PAVEL NIDERMAN D.D.S ATLANTIC DENTAL
Active
Organization
PAVEL NIDERMAN D.D.S ATLANTIC DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAVEL NIDERMAN DDS (PRESIDENT)
(212) 996-5996
Entity
Organization
Contact information
Practice address
2060 LEXINGTON AVE FRNT 2, NEW YORK, NY 10035-1759
(212) 996-5996
(212) 996-0030
Mailing address
2060 LEXINGTON AVE FL 2ND, NEW YORK, NY 10035-1759
(212) 996-5996
(212) 996-0030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
044976
NY
1223G0001X
General Practice Dentistry
044976
NY
1223P0300X
Periodontics
048519
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02241298
—
NY
Enumeration date
04/10/2007
Last updated
07/20/2020
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