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General NPI Number Information
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NPI Number | 1780132670
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Entity Type | Organization
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Legal Business Name | CHELSEA PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 220 W 26TH ST
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City | NEW YORK
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State | NY
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Zip | 10001-6753
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Country | US
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Telephone | 212-243-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 220 W 26TH ST
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City | NEW YORK
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State | NY
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Zip | 10001-6753
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Country | US
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Telephone | 212-243-5437
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOREN BUONOCORE
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Credential | DMD
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Telephone | 914-960-0486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 050738
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License Number State | NY
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