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General NPI Number Information
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NPI Number | 1811268774
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Entity Type | Organization
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Legal Business Name | THE OFFICE FOR DENTAL ARTS, P.C.
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 22424 UNION TPKE STE 1M
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City | BAYSIDE
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State | NY
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Zip | 11364-3650
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Country | US
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Telephone | 718-468-3434
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Fax | 718-465-7576
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Provider Business Mailing Address
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Address Line | 22424 UNION TPKE STE 1M
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City | BAYSIDE
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State | NY
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Zip | 11364-3650
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Country | US
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Telephone | 718-468-3434
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Fax | 718-465-7576
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID STUART HERSHKOWITZ
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Credential | D.M.D.
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Telephone | 718-468-3434
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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 | 35378
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License Number State | NY
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