Individual
DR. ANATOLY TABAK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3130 BRIGHTON 6TH ST, SUITE 1D, BROOKLYN, NY 11235-6954
(718) 648-2067
(718) 648-2147
Mailing address
3130 BRIGHTON 6TH ST, SUITE 1D, BROOKLYN, NY 11235-6954
(718) 648-2067
(718) 648-2147
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
044954
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01437594
—
NY
Enumeration date
07/13/2005
Last updated
07/08/2007
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