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Organization

2ND AVENUE TOOTH DOCTOR,PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GINA COLON (OFFICE MANAGER)
(212) 996-6269
Entity
Organization

Contact information

Practice address
1976 2ND AVE, NEW YORK, NY 10029
(212) 996-6269
Mailing address
1976 2ND AVE, NEW YORK, NY 10029
(212) 996-6269

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02783984
NY
Enumeration date
05/22/2007
Last updated
06/13/2008
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