Organization
GALLERY 57 DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASON KOSTINSKY (CHIEF OPERATING OFFICER)
(212) 246-8700
Entity
Organization
Contact information
Practice address
24 W 57TH ST, SUITE 701, NEW YORK, NY 10019-3918
(212) 246-8700
(212) 246-8707
Mailing address
24 W 57TH ST, SUITE 701, NEW YORK, NY 10019-3918
(212) 246-8700
(212) 246-8707
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
033746
NY
1223P0700X
Prosthodontics
Primary
035303
NY
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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