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Organization
BP DENTISTRY FOR KIDS PC
Active
Organization
BP DENTISTRY FOR KIDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIOT LUTZ DDS (VICE PRESIDENT)
(347) 244-2914
Entity
Organization
Contact information
Practice address
5309 18TH AVE, 2ND FLOOR, BROOKLYN, NY 11204-1523
(718) 644-0287
Mailing address
5309 18TH AVE, 2ND FLOOR, BROOKLYN, NY 11204-1523
(718) 644-0287
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
057524
NY
261QD0000X
Dental Clinic/Center
Primary
057648
NY
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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