MEDICARE: FALGUNI DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	050260	NY

General Provider Information

NPI Number	:	1598013393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALGUNI DENTAL PLLC

Provider Business Mailing Address
First Line	:	563 W 169TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3912
Country	:	US
Telephone Number	:	212-923-3376
Fax Number	:	646-253-1270

Provider Business Practice Location Address
First Line	:	563 W 169TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3912
Country	:	US
Telephone Number	:	212-923-3376
Fax Number	:	646-253-1270

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FALGUNI PATEL
Credential	:	D.D.S.
Telephone Number	:	212-923-3376

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	08/27/2012

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