Organization
AESTHETIC AND IMPLANT DENTAL ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MANISCALCO DDS (OWNER)
(718) 745-0179
Entity
Organization
Contact information
Practice address
7825 4TH AVE, BROOKLYN, NY 11209-3711
(718) 745-0179
Mailing address
7825 4TH AVE, BROOKLYN, NY 11209-3711
(718) 745-0179
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
50-050579
NY
1223P0700X
Prosthodontics
Primary
50-050579
NY
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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