Healthcare Provider Details

I. General information

NPI: 1578370680
Provider Name (Legal Business Name): UTICA DENTAL STUDIO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 SAINT JOHNS PL
BROOKLYN NY
11213-3810
US

IV. Provider business mailing address

1388 SAINT JOHNS PL
BROOKLYN NY
11213-3810
US

V. Phone/Fax

Practice location:
  • Phone: 718-467-6336
  • Fax:
Mailing address:
  • Phone: 718-467-6336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. YADVERINDER SINGH
Title or Position: MEMBER OF LLC
Credential: DMD
Phone: 860-595-8388