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Organization
99 NASSAU AVE DENTAL PLLC
Active
Organization
99 NASSAU AVE DENTAL PLLC
Active
Other names
Dental Made Easy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL BORUCHOV DDS (OWNER)
(718) 507-7781
Entity
Organization
Contact information
Practice address
99 NASSAU AVE, BROOKLYN, NY 11222-3082
(718) 383-0024
Mailing address
11620 QUEENS BLVD, FOREST HILLS, NY 11375-7055
(718) 507-7781
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
056907
NY
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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