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General NPI Number Information
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NPI Number | 1407031867
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Entity Type | Organization
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Legal Business Name | TRIBECA ORAL AND MAXILLOFACIAL SURGERY, PLLC
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 21 MURRAY ST 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10007-2239
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Country | US
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Telephone | 212-267-3300
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Fax | 212-267-3304
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Provider Business Mailing Address
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Address Line | 21 MURRAY ST 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10007-2239
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Country | US
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Telephone | 212-267-3300
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Fax | 212-267-3304
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Authorized Official
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Title or Position | MEMBER
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Name | DR. BRETT KING
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Credential | D.D.S.
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Telephone | 212-267-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 051457
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License Number State | NY
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