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General NPI Number Information
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NPI Number | 1598351587
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Entity Type | Organization
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Legal Business Name | UB DENTAL DENTAL SERVICES
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Dates
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Enumeration Date | 12/15/2020
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 527 MANHATTAN AVE
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City | NEW YORK
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State | NY
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Zip | 10027-5236
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Country | US
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Telephone | 917-915-4504
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Fax |
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Provider Business Mailing Address
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Address Line | 30 CENTRAL PARK S RM 13C
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City | NEW YORK
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State | NY
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Zip | 10019-1646
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Country | US
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Telephone | 917-915-4504
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID JANASH
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Credential | DMD
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Telephone | 917-915-4504
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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 |
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License Number State |
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