Healthcare Provider Details

I. General information

NPI: 1316309347
Provider Name (Legal Business Name): HARBOR DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 03/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 RIVER STREET MEI ZHANG, DDS
SLEEPY HOLLOW NY
10591
US

IV. Provider business mailing address

55 RIVER STREET HARBOR DENTAL
SLEEPY HOLLOW NY
10591
US

V. Phone/Fax

Practice location:
  • Phone: 914-923-6688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number049193
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number049193
License Number StateNY

VIII. Authorized Official

Name: MEI ZHANG
Title or Position: DENTIST
Credential:
Phone: 914-923-6688