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General NPI Number Information
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NPI Number | 1639250541
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Entity Type | Organization
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Legal Business Name | FIRST CLASS FAMILY DENTISTRY OF NEW YORK LLC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 608 5TH AVE STE 808
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City | NEW YORK
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State | NY
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Zip | 10020-2303
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Country | US
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Telephone | 212-245-5817
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Fax | 212-664-1950
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Provider Business Mailing Address
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Address Line | 608 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10020-2303
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Country | US
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Telephone | 212-245-5817
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Fax | 212-664-1950
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANCA SANDULESCU
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Credential | OFFICE M,ANAGER
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Telephone | 516-581-6624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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