# LALABA DENTAL PC

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

## Provider details

- **NPI number:** 1588983738
- **Authorized official:** MITA SHARAD PATEL D.D.S (PRESIDENT)
- **Authorized official phone:** (516) 365-3701

## Contact information

- **Practice address:** 679 E 138TH ST, BRONX, NY 10454-3307
- **Practice address phone:** (718) 665-6065
- **Practice address fax:** (718) 665-6065
- **Mailing address:** 2 WOODLAND CT, ROSLYN, NY 11576-1432
- **Mailing address phone:** (516) 365-3701
- **Mailing address fax:** (516) 365-3701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/27/2010
- **Last updated:** 05/27/2010