Organization
1995 BROADWAY DENTAL ARTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC LIECHTUNG DDS (PRESIDENT)
(732) 610-8265
Entity
Organization
Contact information
Practice address
1995 BROADWAY, NEW YORK, NY 10023-5882
(212) 247-2330
Mailing address
1995 BROADWAY, NEW YORK, NY 10023-5882
(212) 247-2330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
040754
NY
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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