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Organization
YOUR DENTAL, PC
Active
Organization
YOUR DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN B KO D.D.S. (PRESIDENT)
(212) 682-5580
Entity
Organization
Contact information
Practice address
501 5TH AVE, SUITE 703, NEW YORK, NY 10017-6107
(212) 682-5580
(212) 692-9355
Mailing address
501 5TH AVE, SUITE 703, NEW YORK, NY 10017-6107
(212) 682-5580
(212) 692-9355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053599
NY
Other
Enumeration date
09/19/2007
Last updated
08/20/2013
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