# NYU COLLEGE OF DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FACULTY PRACTICE SOUTH
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780804344
- **Authorized official:** DR. ROBERT S GLICKMAN DDS (ASSOC DEAN CLINICAL AFFAIRS)
- **Authorized official phone:** (212) 443-1322

## Contact information

- **Practice address:** 726 BROADWAY, SUITE 350, NEW YORK, NY 10003-9502
- **Practice address phone:** (212) 443-1300
- **Practice address fax:** (212) 443-1331
- **Mailing address:** 726 BROADWAY, SUITE 350, NEW YORK, NY 10003-9502
- **Mailing address phone:** (212) 443-1300
- **Mailing address fax:** (212) 443-1331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 261QD0000X | Dental Clinic/Center | 021314-2 | NY | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 04/16/2019