Organization
BROOKLYN SMILE DENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY HERSKOVITS DDS (DENTIST)
(718) 745-3456
Entity
Organization
Contact information
Practice address
9412 4TH AVE, BROOKLYN, NY 11209-7301
(718) 745-3456
(718) 745-3205
Mailing address
9412 4TH AVE, BROOKLYN, NY 11209-7301
(718) 745-3456
(718) 745-3205
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
36187
NY
1223P0106X
Oral and Maxillofacial Pathology Dentistry
36187
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
46724
NY
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
NY
Other
Enumeration date
03/17/2015
Last updated
03/30/2015
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