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General NPI Number Information
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NPI Number | 1780850073
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Entity Type | Organization
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Legal Business Name | BBSJ DENTAL CARE PC
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 8928 MERRICK BLVD
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone | 718-291-9456
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Fax | 718-558-0861
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Provider Business Mailing Address
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Address Line | 8928 MERRICK BLVD
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City | JAMAICA
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State | NY
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Zip | 11432
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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 | GENERAL DENTIST
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Name | DR. PAUL I ROSEN
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Credential | DMD
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Telephone | 718-291-9456
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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 | 031862
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License Number State | NY
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