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General NPI Number Information
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NPI Number | 1154594430
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Entity Type | Individual
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Provider Name | MICHELE LANDOLT D.M.D
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Gender | Female
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 12 E 41ST ST 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10017-6221
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Country | US
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Telephone | 212-686-3953
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Fax | 212-889-5558
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Provider Business Mailing Address
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Address Line | 12 E 41ST ST 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10017-6221
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Country | US
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Telephone | 212-686-3953
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Fax | 212-889-5558
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 055912
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License Number State | NY
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