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General NPI Number Information
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NPI Number | 1780053108
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Entity Type | Organization
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Legal Business Name | SBK DENTAL, LLC
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 385 4TH AVE UNIT 2
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City | BROOKLYN
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State | NY
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Zip | 11215-3201
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Country | US
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Telephone | 347-708-9777
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Fax | 347-708-9774
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Provider Business Mailing Address
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Address Line | 385 4TH AVE UNIT 2
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City | BROOKLYN
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State | NY
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Zip | 11215-3201
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Country | US
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Telephone | 347-708-9777
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Fax | 347-708-9774
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Authorized Official
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Title or Position | ORTHODONTIST/OWNER
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Name | DR. ANKUSH KHANNA
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Credential | DMD
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Telephone | 347-708-9777
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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 | 054655-1
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License Number State | NY
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