Organization
WESTSIDE DENTIST, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNA BARANTSEVICH (PRESIDENT)
(212) 247-5050
Entity
Organization
Contact information
Practice address
57 W 58TH ST, SUITE 2C, NEW YORK, NY 10019-1630
(212) 247-5050
(212) 581-3596
Mailing address
57 W 58TH ST, SUITE 2C, NEW YORK, NY 10019-1630
(212) 247-5050
(212) 581-3596
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
046914
NY
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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