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General NPI Number Information
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NPI Number | 1376694166
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Entity Type | Organization
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Legal Business Name | BNY DENTAL P.C.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 205 W END AVE APT. 1F
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City | NEW YORK
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State | NY
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Zip | 10023-4804
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Country | US
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Telephone | 646-414-6238
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Fax |
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Provider Business Mailing Address
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Address Line | 205 W END AVE APT. 1F
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City | NEW YORK
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State | NY
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Zip | 10023-4804
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Country | US
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Telephone | 646-414-6238
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATALIA BARTKOVA
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Credential | DDS
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Telephone | 646-414-6238
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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 | 050362
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License Number State | NY
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