Organization
DR. TAJUL ISLAM DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAJUL ISLAM D.D.S. (PRESIDENT)
(718) 622-1868
Entity
Organization
Contact information
Practice address
1236 FULTON ST, BROOKLYN, NY 11216-2093
(718) 622-1868
Mailing address
1236 FULTON ST, BROOKLYN, NY 11216-2093
(718) 622-1868
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
050581
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02392501
—
NY
01
—
9179252
DORAL DENTAL IPA OF NEW Y
—
Enumeration date
07/11/2007
Last updated
07/11/2007
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