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General NPI Number Information
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NPI Number | 1730332727
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Entity Type | Organization
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Legal Business Name | WASHINGTON HEIGHTS DENTAL
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 600 W 161ST ST SUITE 1D
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City | NEW YORK
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State | NY
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Zip | 10032-5609
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Country | US
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Telephone | 212-928-1298
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Fax |
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Provider Business Mailing Address
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Address Line | 600 W 161ST ST SUITE 1D
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City | NEW YORK
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State | NY
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Zip | 10032-5609
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN KLEIN
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Credential |
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Telephone | 212-928-1298
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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 | 050750
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License Number State | NY
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