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General NPI Number Information
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NPI Number | 1821254251
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Entity Type | Organization
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Legal Business Name | PERIODONTICS & IMPLANTS OF MIDTOWN, PLLC
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 57 W 57TH ST STE 804
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City | NEW YORK
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State | NY
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Zip | 10019-2808
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Country | US
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Telephone | 212-935-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 57 W 57TH ST STE 804
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City | NEW YORK
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State | NY
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Zip | 10019-2808
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Country | US
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Telephone | 212-935-4444
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. CHERRY LIBRAMONTE
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Credential | DMD
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Telephone | 212-935-4444
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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 | 050669
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License Number State | NY
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