Organization
21ST CENTURY FAMILY DENTAL P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRYAR SEDGH DDS (PERSIDENT)
(718) 384-2662
Entity
Organization
Contact information
Practice address
738 BROADWAY, BROOKLYN, NY 11206-4403
(718) 384-2662
(718) 384-6408
Mailing address
738 BROADWAY, BROOKLYN, NY 11206-4403
(718) 384-2662
(718) 384-6408
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01768034
—
NY
Enumeration date
08/12/2013
Last updated
08/12/2013
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