Organization
BRAD LEVINE DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN GOLDSTEIN (MANAGER)
(516) 767-9300
Entity
Organization
Contact information
Practice address
14 MAPLE ST, SUITE 104, PORT WASHINGTON, NY 11050-2967
(516) 767-9300
(516) 767-7392
Mailing address
14 MAPLE ST, SUITE 104, PORT WASHINGTON, NY 11050-2967
(516) 767-9300
(516) 767-7392
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
040521
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02254731
—
NY
Enumeration date
01/23/2012
Last updated
02/01/2012
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