Organization
COLUMBUS AVENUE DENTAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL POVEDA DDS (PRESIDENT)
(212) 749-5000
Entity
Organization
Contact information
Practice address
902 COLUMBUS AVE, NEW YORK, NY 10025
(212) 749-5000
(212) 749-5522
Mailing address
902 COLUMBUS AVE, NEW YORK, NY 10025
(212) 749-5000
(212) 749-5522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046108
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01668193
—
NY
05
—
02145435
—
NY
Enumeration date
07/05/2007
Last updated
08/22/2020
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