Organization
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Active
Other names
Dentistry Department of Mount Sinai
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL MACNEILL (VICE PRESIDENT, CBO DIRECTOR)
(646) 605-8112
Entity
Organization
Contact information
Practice address
ONE GUSTAVE L. LEVY PLACE, NEW YORK, NY 10029
(212) 241-0300
(212) 996-9793
Mailing address
ONE GUSTAVE L. LEVY PLACE, NEW YORK, NY 10029
(212) 241-0300
(212) 996-9793
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
04/27/2015
Last updated
04/27/2015
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