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General NPI Number Information
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NPI Number | 1215137260
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Entity Type | Organization
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Legal Business Name | CENTURY DENTAL ASSOCIATION
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 88 FULTON ST GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10038-2807
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Country | US
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Telephone | 212-587-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 921
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City | NEW YORK
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State | NY
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Zip | 10272-0921
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Country | US
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Telephone | 212-587-3000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MEHRAN MOROVATI
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Credential | DDS
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Telephone | 212-587-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 044375-1
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License Number State | NY
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