Organization
MADISON AVENUE PERIODONTICS, P.C.
Active
Other names
Madison Avenue Periodontics, Matthew Neary DDS & John Lanzetta DMD PC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA-ROCHA (SR CREDENTIALING TEAM LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
501 MADISON AVE, 22ND FLOOR, NY, NY 10022
(212) 755-1144
(212) 371-9629
Mailing address
501 MADISON AVE, 22ND FLOOR, NY, NY 10022
(212) 755-1144
(212) 371-9629
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
041733
NY
122300000X
Dentist
Primary
047299
NY
122300000X
Dentist
35077
NY
Other
Enumeration date
11/15/2006
Last updated
09/18/2024
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