Organization
156 5TH AVE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIDGET GLAZAROV DDS (OWNER)
(917) 403-7806
Entity
Organization
Contact information
Practice address
156 5TH AVE STE 900, NEW YORK, NY 10010-7763
(917) 403-7806
Mailing address
44 W 22ND ST APT 3, NEW YORK, NY 10010-5859
(917) 403-7806
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043767288
DENTAL
NY
Enumeration date
02/03/2022
Last updated
02/03/2022
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