Organization
5TH AVENUE DENTAL ASSOC LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE DIACOUMAKOS (OWNER)
(718) 745-4422
Entity
Organization
Contact information
Practice address
7815 5TH AVE, BROOKLYN, NY 11209-3703
(718) 745-4422
(718) 745-8558
Mailing address
7815 5TH AVE, BROOKLYN, NY 11209-3703
(718) 745-4422
(718) 745-8558
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
03/27/2007
Last updated
09/08/2020
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