Organization
4TH AVENUE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. ANDREW MARON DDS (OWNER)
(718) 439-2876
Entity
Organization
Contact information
Practice address
5404 4TH AVE, BROOKLYN, NY 11220-3006
(718) 439-2876
(718) 439-2879
Mailing address
5404 4TH AVE, BROOKLYN, NY 11220-3006
(718) 439-2876
(718) 439-2879
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
027990
NY
1223G0001X
General Practice Dentistry
Primary
18369
NJ
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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