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General NPI Number Information
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NPI Number | 1316285711
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Entity Type | Organization
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Legal Business Name | COMMUNITY DENTAL CARE OF NYC PLLC
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Dates
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Enumeration Date | 01/21/2013
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 47 E 167TH ST
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City | BRONX
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State | NY
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Zip | 10452-8206
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Country | US
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Telephone | 718-293-1603
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Fax | 718-293-1602
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Provider Business Mailing Address
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Address Line | 47 E 167TH ST
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City | BRONX
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State | NY
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Zip | 10452-8206
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Country | US
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Telephone | 718-293-1603
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Fax | 718-293-1602
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Authorized Official
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Title or Position | MEMBER / MANAGER
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Name | MR. ANDREW SAROWITZ
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Credential | DDS
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Telephone | 718-293-1603
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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 | 055136
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License Number State | NY
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