Individual
CHIRANJIB DUTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
36 61 MAIN STREET, FLUSHING, NY 11354
(718) 539-8762
(718) 539-4186
Mailing address
36 61 MAIN STREET, FLUSHING, NY 11354
(718) 539-8762
(718) 539-4186
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
044117
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01418428
—
NY
Enumeration date
01/25/2007
Last updated
07/08/2007
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