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General NPI Number Information
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NPI Number | 1801107347
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Entity Type | Organization
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Legal Business Name | CENTRAL PARK PERIODONTICS, P.C.
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 40 CENTRAL PARK S SUITE 2E
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City | NEW YORK
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State | NY
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Zip | 10019-1633
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Country | US
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Telephone | 212-355-5595
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Fax | 212-355-5596
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Provider Business Mailing Address
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Address Line | 40 CENTRAL PARK S SUITE 2E
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City | NEW YORK
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State | NY
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Zip | 10019-1633
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Country | US
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Telephone | 212-355-5595
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Fax | 212-355-5596
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Authorized Official
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Title or Position | PRESIDENBT
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Name | DR. ALAN ARTHUR WINTER
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Credential | DDS
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Telephone | 212-355-5595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 030306
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License Number State | NY
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