Organization
LUTHERAN MEDICAL CENTER
Active
Parent organization
LUTHERAN MEDICAL CENTER
Other names
Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUTHERAN MEDICAL CENTER
Authorized official
ASTRID GONZALEZ (SENIOR VICE PRESIDENT)
(718) 630-8973
Entity
Organization
Contact information
Practice address
150 55TH ST, DENTAL DEPARTMENT, BROOKLYN, NY 11220-2508
(718) 630-6875
Mailing address
5800 3RD AVE, MANAGED CARE DEPARTMENT, BROOKLYN, NY 11220-3702
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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