Organization
BP DENTISTRY FOR KIDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIOT LUTZ DDS (VICE PRESIDENT)
(347) 244-2914
Entity
Organization
Contact information
Practice address
5309 18TH AVE, 2ND FLOOR, BROOKLYN, NY 11204-1523
(718) 644-0287
Mailing address
5309 18TH AVE, 2ND FLOOR, BROOKLYN, NY 11204-1523
(718) 644-0287
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
057524
NY
261QD0000X
Dental Clinic/Center
Primary
057648
NY
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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