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General NPI Number Information
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NPI Number | 1831203199
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Entity Type | Organization
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Legal Business Name | A H DENTAL PC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 65 BROADWAY STE 408
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City | NEW YORK
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State | NY
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Zip | 10006-2546
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Country | US
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Telephone | 212-430-3888
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Fax | 212-430-3889
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Provider Business Mailing Address
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Address Line | 65 BROADWAY SUITE 408
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City | NEW YORK
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State | NY
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Zip | 10006-2546
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Country | US
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Telephone | 212-430-3888
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Fax | 212-430-3889
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXANDER HEIFITZ
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Credential | DDS
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Telephone | 212-430-3888
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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 | 0471301
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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