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General NPI Number Information
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NPI Number | 1548406390
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Entity Type | Organization
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Legal Business Name | FOLEY SQUARE DENTAL, P.C.
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 05/01/2010
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Provider Practice Location Address
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Address Line | 175 MONROE ST LOWER LEVEL
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City | BROOKLYN
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State | NY
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Zip | 11216-6718
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Country | US
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Telephone | 718-623-6222
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Fax | 717-623-6225
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Provider Business Mailing Address
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Address Line | 175 MONROE ST LOWER LEVEL
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City | BROOKLYN
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State | NY
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Zip | 11216-6718
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Country | US
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Telephone | 718-623-6222
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Fax | 717-623-6225
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FREDERICK SANDS
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Credential | D.D.S.
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Telephone | 718-623-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 26089
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License Number State | NY
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