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General NPI Number Information
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NPI Number | 1013149772
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Entity Type | Organization
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Legal Business Name | SUPERLATIVE SMILES DENTAL P.C.
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 839 57TH ST 1ST FL
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City | BROOKLYN
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State | NY
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Zip | 11220-3633
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Country | US
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Telephone | 718-853-0253
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Fax | 718-853-0260
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Provider Business Mailing Address
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Address Line | 839 57TH ST 1ST FL
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City | BROOKLYN
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State | NY
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Zip | 11220-3633
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Country | US
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Telephone | 718-853-0253
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Fax | 718-853-0260
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Authorized Official
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Title or Position | DR
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Name | DR. DAVID LUK
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Credential | DMD, MS
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Telephone | 718-853-0253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 050894
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License Number State | NY
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