Organization
MDA DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC MORDECAI LIECHTUNG (OWNER)
(212) 247-2330
Entity
Organization
Contact information
Practice address
1995 BROADWAY STE 200, NEW YORK, NY 10023-5882
(212) 247-2330
Mailing address
1995 BROADWAY STE 200, NEW YORK, NY 10023-5882
(212) 247-2330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
040754-1
NY
Other
Enumeration date
12/26/2012
Last updated
12/26/2012
Update your record
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