Individual
HIDEMI TAKEZAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
481 8TH AVE, SUITE 725, NEW YORK, NY 10001-1809
(212) 967-0817
(212) 967-0817
Mailing address
481 8TH AVE, SUITE 725, NEW YORK, NY 10001-1809
(212) 967-0817
(212) 967-0817
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02521300
NJ
1223G0001X
General Practice Dentistry
Primary
047219
NY
Other
Enumeration date
02/26/2012
Last updated
10/01/2014
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