# BP DENTISTRY FOR KIDS PC

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

## Provider details

- **NPI number:** 1861944043
- **Authorized official:** DR. ELLIOT LUTZ DDS (VICE PRESIDENT)
- **Authorized official phone:** (347) 244-2914

## Contact information

- **Practice address:** 5309 18TH AVE, 2ND FLOOR, BROOKLYN, NY 11204-1523
- **Practice address phone:** (718) 644-0287
- **Mailing address:** 5309 18TH AVE, 2ND FLOOR, BROOKLYN, NY 11204-1523
- **Mailing address phone:** (718) 644-0287

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 057524 | NY | — |
| 261QD0000X | Dental Clinic/Center | 057648 | NY | Yes |

## Other

- **Enumeration date:** 11/03/2016
- **Last updated:** 11/03/2016