Individual
DR. CHARLES JOHN PTAK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
92 NORMAN AVE, BROOKLYN, NY 11222-2934
(718) 383-5551
(718) 349-0930
Mailing address
92 NORMAN AVE, BROOKLYN, NY 11222-2934
(718) 383-5551
(718) 349-0930
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
034744
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00782729
—
NY
Enumeration date
07/30/2006
Last updated
07/08/2007
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