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General NPI Number Information
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NPI Number | 1861879827
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Entity Type | Individual
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Provider Name | JOHN CHRISTOPHER DOLAN MA, DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 327 CENTRAL PARK WEST SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10025
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Country | US
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Telephone | 212-998-9396
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Fax | 212-280-3447
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Provider Business Mailing Address
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Address Line | 421 FIRST AVENUE CLINIC 2W
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City | NEW YORK
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State | NY
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Zip | 10010
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Country | US
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Telephone | 718-685-6084
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Fax | 212-995-4843
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 055388
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License Number State | NY
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