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General NPI Number Information
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NPI Number | 1386336709
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Entity Type | Organization
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Legal Business Name | BCT DENTAL PLLC
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 370 ATLANTIC AVE
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City | FREEPORT
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State | NY
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Zip | 11520-4245
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Country | US
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Telephone | 718-781-3393
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Fax |
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Provider Business Mailing Address
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Address Line | 310 W 97TH ST APT 41
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City | NEW YORK
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State | NY
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Zip | 10025-6127
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Country | US
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Telephone | 718-781-3393
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. BIANA CHANNEL TATARSKY
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Credential | DMD
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Telephone | 718-781-3393
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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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