Organization
DENTAL EXPRESS BROADWAY, PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHMET DIKENGIL DDS (PRESIDENT)
(212) 928-1298
Entity
Organization
Contact information
Practice address
600 W 161ST ST, NEW YORK, NY 10032-5609
(212) 928-1298
Mailing address
600 W 161ST ST, NEW YORK, NY 10032-5609
(212) 928-1298
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
039671-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03300396
—
NY
Enumeration date
11/18/2011
Last updated
11/18/2011
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