Organization
12TH STREET DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID JANASH DMD (PRESIDENT AND CEO)
(917) 915-4504
Entity
Organization
Contact information
Practice address
77 E 12TH ST, NEW YORK, NY 10003-5002
(917) 915-4504
Mailing address
30 CENTRAL PARK S RM 13C, NEW YORK, NY 10019-1646
(212) 355-2000
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
051610
NY
Other
Enumeration date
09/06/2018
Last updated
05/30/2024
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