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General NPI Number Information
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NPI Number | 1134002389
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Entity Type | Organization
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Legal Business Name | MODERN PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 24 5TH AVE LBBY 1
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City | NEW YORK
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State | NY
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Zip | 10011-8858
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Country | US
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Telephone | 646-540-9910
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Fax |
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Provider Business Mailing Address
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Address Line | 24 5TH AVE LBBY 1
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City | NEW YORK
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State | NY
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Zip | 10011-8858
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Country | US
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Telephone | 646-540-9910
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SEAN CHARLES ADLER
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Credential | DMD
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Telephone | 267-235-3549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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