Organization
GENTLE DENTAL CHURCH AVENUE PLLC
Active
Other names
Gentle Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT FATAKHOV DDS (OWNER)
(718) 485-4111
Entity
Organization
Contact information
Practice address
4711 CHURCH AVE, 2ND FLOOR, DENTAL SUITE, BROOKLYN, NY 11203-3209
(718) 485-4111
Mailing address
4711 CHURCH AVE, 2ND FLOOR, DENTAL SUITE, BROOKLYN, NY 11203-3209
(718) 485-4111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
051345
NY
122300000X
Dentist
Primary
054434
NY
Other
Enumeration date
03/24/2017
Last updated
03/24/2017
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