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General NPI Number Information
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NPI Number | 1528231214
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Entity Type | Organization
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Legal Business Name | TAFT'S DENTAL P.C.
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 324 BEACH 59TH ST
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City | ARVERNE
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State | NY
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Zip | 11692-1642
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Country | US
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Telephone | 718-945-9500
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Fax | 718-945-6302
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Provider Business Mailing Address
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Address Line | 324 BEACH 59TH ST
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City | ARVERNE
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State | NY
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Zip | 11692-1642
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Country | US
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Telephone | 718-945-9500
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Fax | 718-945-6302
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LYUBA I TAFT
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Credential | D.D.S.
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Telephone | 718-945-9500
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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 | 049791
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License Number State | NY
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