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Organization
MANHATTAN DENTISTRY COSMETY
Active
Organization
MANHATTAN DENTISTRY COSMETY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IBELKA VARGAS (OWNER)
(212) 568-1003
Entity
Organization
Contact information
Practice address
461 FORT WASHINGTON AVE APT 1, NEW YORK, NY 10033-4632
(212) 568-1003
(212) 568-5715
Mailing address
461 FORT WASHINGTON AVE APT 1, NEW YORK, NY 10033-4632
(212) 568-1003
(212) 568-5715
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050317-1
NY
1223G0001X
General Practice Dentistry
052543
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2329808
—
NY
05
—
2711071
—
NY
Enumeration date
01/23/2013
Last updated
01/23/2013
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