Individual
KA LI LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 DEKALB AVENUE, BROOKLYN, NY 11201-5425
(718) 250-6604
Mailing address
345 E 24TH ST, NEW YORK, NY 10010-4020
(212) 998-9800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
064761
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2023
Last updated
04/21/2026
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