Organization
CONCOURSE WEST DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MAGID DMD (MANAGER)
(718) 992-0410
Entity
Organization
Contact information
Practice address
880 RIVER AVENUE, BRONX, NY 10452
(718) 992-0410
Mailing address
880 RIVER AVENUE, BRONX, NY 10452
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
050404
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02408928
—
NY
Enumeration date
03/15/2013
Last updated
03/15/2013
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