Organization
MARK R. HERZOG, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK R. HERZOG D.D.S. (PRESIDENT)
(718) 259-1110
Entity
Organization
Contact information
Practice address
8421 BAY PKWY, BROOKLYN, NY 11214-3303
(718) 259-1110
(718) 259-1198
Mailing address
8421 BAY PKWY, BROOKLYN, NY 11214-3303
(718) 259-1110
(718) 259-1198
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
038484
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01200797
—
NY
Enumeration date
06/04/2007
Last updated
08/22/2020
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