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Organization

DR. BRIAN KETOVER DMD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN KETOVER DMD (DENTIST)
(718) 168-8400
Entity
Organization

Contact information

Practice address
580 5TH AVE, BROOKLYN, NY 11215-5436
(718) 768-8400
(718) 768-7450
Mailing address
580 5TH AVE, BROOKLYN, NY 11215-5436
(718) 768-8400
(718) 768-7450

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
035400
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00532958
NY
Enumeration date
07/21/2011
Last updated
07/21/2011
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