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General NPI Number Information
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NPI Number | 1376004887
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Entity Type | Organization
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Legal Business Name | MANHATTAN DENTAL CARE PLLC
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 250 E 63RD ST UNIT 1-A
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City | NEW YORK
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State | NY
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Zip | 10065-7661
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Country | US
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Telephone | 516-506-0000
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Fax | 516-336-3664
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Provider Business Mailing Address
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Address Line | 5 COMMACK RD 2ND FL
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City | COMMACK
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State | NY
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Zip | 11725
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Country | US
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Telephone | 516-506-0000
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Fax | 516-336-3664
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARRY CHASE
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Credential | DDS
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Telephone | 516-506-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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