# BRUCE J LISH DDS PLLC

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

## Provider details

- **NPI number:** 1457747198
- **Authorized official:** DR. BRUCE J LISH DDS (OWNER)
- **Authorized official phone:** (718) 763-1817

## Contact information

- **Practice address:** 7224 AVENUE T, BROOKLYN, NY 11234-6235
- **Practice address phone:** (718) 763-1817
- **Practice address fax:** (917) 591-4970
- **Mailing address:** 7224 AVENUE T, BROOKLYN, NY 11234-6235
- **Mailing address phone:** (718) 763-1817
- **Mailing address fax:** (917) 591-4970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 045725 | NY | Yes |

## Other

- **Enumeration date:** 04/09/2015
- **Last updated:** 04/09/2015