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Organization

810 DENTAL ASSOCIATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. REUVEN D MOHL DDS (PRESIDENT)
(718) 824-4383
Entity
Organization

Contact information

Practice address
810 PELHAM PKWY S, STE. A, BRONX, NY 10462-1143
(718) 824-4383
Mailing address
810 PELHAM PKWY S, STE. A, BRONX, NY 10462-1143

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
049286
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
049298
LICENSE
NY
Enumeration date
10/10/2007
Last updated
08/26/2013
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