# 99 NASSAU AVE DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Made Easy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922509348
- **Authorized official:** DR. RAFAEL BORUCHOV DDS (OWNER)
- **Authorized official phone:** (718) 507-7781

## Contact information

- **Practice address:** 99 NASSAU AVE, BROOKLYN, NY 11222-3082
- **Practice address phone:** (718) 383-0024
- **Mailing address:** 11620 QUEENS BLVD, FOREST HILLS, NY 11375-7055
- **Mailing address phone:** (718) 507-7781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 056907 | NY | Yes |

## Other

- **Enumeration date:** 02/21/2018
- **Last updated:** 02/21/2018