Organization
MANHATTAN PEDIATRIC DENTAL GROUP, PC
Active
Other names
Eastside Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA QUINTEROS (CREDENTIALING MANAGER)
(212) 879-3956
Entity
Organization
Contact information
Practice address
192 E 75TH ST, NEW YORK, NY 10021-3242
(212) 879-3956
Mailing address
125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
(724) 698-2500
(844) 399-0385
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/28/2023
Last updated
08/01/2023
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