# SERENE DENTAL LLC

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

## Provider details

- **NPI number:** 1518297852
- **Authorized official:** ALTAY KHANMAMEDOV DDS (OWNER/MANAGER)
- **Authorized official phone:** (917) 881-5977

## Contact information

- **Practice address:** 315 W 57TH ST, SUITE 209, NEW YORK, NY 10019-3158
- **Practice address phone:** (917) 338-6358
- **Practice address fax:** (917) 470-9486
- **Mailing address:** 801 W 181ST ST, APT. 26, NEW YORK, NY 10033-4542
- **Mailing address phone:** (917) 881-5977
- **Mailing address fax:** (917) 338-7771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 051162 | NY | Yes |

## Other

- **Enumeration date:** 01/08/2010
- **Last updated:** 01/08/2010