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General NPI Number Information
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NPI Number | 1346707916
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Entity Type | Organization
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Legal Business Name | 5D DENTAL PLLC
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Dates
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Enumeration Date | 03/01/2019
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 150 IRVING PLACE
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City | WOODMERE
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State | NY
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Zip | 11598
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Country | US
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Telephone | 516-374-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 150 IRVING PLACE
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City | WOODMERE
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State | NY
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Zip | 11598
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Country | US
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Telephone | 516-374-9100
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Fax |
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Authorized Official
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Title or Position | MNGR
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Name | MARKUS L WEITZ
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Credential | DDS
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Telephone | 516-457-3111
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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 |
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License Number State |
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