Healthcare Provider Details
I. General information
NPI: 1326890609
Provider Name (Legal Business Name): DENTIQUE NYC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
274 MADISON AVE RM 1702
NEW YORK NY
10016-0716
US
IV. Provider business mailing address
274 MADISON AVE RM 1702
NEW YORK NY
10016-0716
US
V. Phone/Fax
- Phone: 718-679-2757
- Fax:
- Phone: 718-679-2757
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223D0001X |
| Taxonomy | Public Health Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KARINA
ZAYGERMAKER
Title or Position: DOCTOR
Credential: DDS
Phone: 212-889-8870