Organization
99 NASSAU AVE DENTAL PLLC
Active
Other names
Dental Made Easy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL BORUCHOV DDS (OWNER)
(718) 507-7781
Entity
Organization
Contact information
Practice address
99 NASSAU AVE, BROOKLYN, NY 11222-3082
(718) 383-0024
Mailing address
11620 QUEENS BLVD, FOREST HILLS, NY 11375-7055
(718) 507-7781
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
056907
NY
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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