Organization
RANDY ZULTOWSKY DDS, P.C.
Active
Other names
Upper West Side Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY ZULTOWSKY DDS (PRESIDENT)
(917) 952-5642
Entity
Organization
Contact information
Practice address
315 W 70TH ST, NEW YORK, NY 10023-3504
(917) 952-5642
Mailing address
11 W 69TH ST APT 1C, NEW YORK, NY 10023-4700
(917) 952-5642
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
055100
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03530783
—
NY
Enumeration date
08/25/2017
Last updated
08/25/2017
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