Organization
COLUMBIA UNIV DENTAL SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONNIE MYERS DDS (ASSOCIATE DEAN FOR CLINICAL AFFAIRS)
(212) 305-5686
Entity
Organization
Contact information
Practice address
622 W 168TH ST, VANDERBILT CLINIC 9TH FLOOR, NEW YORK, NY 10032-3720
(212) 305-5686
Mailing address
630 W 168TH ST, P&S BOX 30, NEW YORK, NY 10032-3725
(212) 305-5686
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00302034
—
NY
Enumeration date
09/18/2008
Last updated
09/18/2008
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