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General NPI Number Information
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NPI Number | 1649417676
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Entity Type | Organization
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Legal Business Name | JONATHAN ROBERTS DDS & CRAIG SIROTA DMD PC
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 501 MADISON AVENUE 24TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10022
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Country | US
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Telephone | 212-758-9690
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Fax | 212-838-1137
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Provider Business Mailing Address
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Address Line | 501 MADISON AVENUE 24TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10022
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Country | US
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Telephone | 212-758-9690
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Fax | 212-838-1137
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Authorized Official
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Title or Position | VICE PRESIDENT/ CO OWNER
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Name | DR. CRAIG ALLYN SIROTA
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Credential | DMD
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Telephone | 212-758-9690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 034632
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 022937
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 048076-1
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License Number State | NY
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