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General NPI Number Information
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NPI Number | 1801067715
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Entity Type | Organization
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Legal Business Name | ALL IN ONE DENTAL
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 4521 3RD AVE
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City | BRONX
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State | NY
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Zip | 10457-1515
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Country | US
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Telephone | 718-220-2030
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Fax | 718-220-2032
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Provider Business Mailing Address
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Address Line | 4521 THIRD AVE
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City | BRONX
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State | NY
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Zip | 10457
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Country | US
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Telephone | 718-220-2030
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Fax | 718-220-2032
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | MS. KARLA WENDY ISAACS
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Credential | D.D.S
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Telephone | 718-220-2030
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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 | 047607
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License Number State | NY
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