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Organization
SERENE DENTAL LLC
Active
Organization
SERENE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALTAY KHANMAMEDOV DDS (OWNER/MANAGER)
(917) 881-5977
Entity
Organization
Contact information
Practice address
315 W 57TH ST, SUITE 209, NEW YORK, NY 10019-3158
(917) 338-6358
(917) 470-9486
Mailing address
801 W 181ST ST, APT. 26, NEW YORK, NY 10033-4542
(917) 881-5977
(917) 338-7771
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
051162
NY
Other
Enumeration date
01/08/2010
Last updated
01/08/2010
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