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General NPI Number Information
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NPI Number | 1750832713
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Entity Type | Organization
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Legal Business Name | UES DENTAL PLLC
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 235 W 14TH ST STORE FRONT
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City | NEW YORK
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State | NY
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Zip | 10011-7102
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Country | US
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Telephone | 212-675-2044
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Fax | 212-675-0482
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Provider Business Mailing Address
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Address Line | 235 W 14TH ST STORE FRONT
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City | NEW YORK
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State | NY
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Zip | 10011-7102
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Country | US
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Telephone | 212-675-2044
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Fax | 212-675-0482
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RATNA MONGA
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Credential |
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Telephone | 212-675-2044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 053273
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License Number State | NY
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