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Organization
PREMIER DENTAL,PC
Active
Organization
PREMIER DENTAL,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE J BRUCKNER DDS (PRESIDENT)
(917) 602-9533
Entity
Organization
Contact information
Practice address
1155 BROADWAY, BROOKLYN, NY 11221-3025
(718) 241-8050
Mailing address
25 MAXINE AVE, PLAINVIEW, NY 11803-3606
(917) 602-9533
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00295143
NY
Other
Enumeration date
09/17/2008
Last updated
09/17/2008
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