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General NPI Number Information
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NPI Number | 1871727131
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Entity Type | Organization
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Legal Business Name | TRIBECA DENTAL STUDIO
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 05/14/2009
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Provider Practice Location Address
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Address Line | 54 WARREN STREET TRIBECA DENTAL STUDIO
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City | NYC
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State | NY
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Zip | 10007
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Country | US
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Telephone | 212-561-5303
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Fax | 646-652-8190
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Provider Business Mailing Address
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Address Line | 54 WARREN ST TRIBECA DENTAL STUDIO
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City | NYC
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State | NY
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Zip | 10007
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Country | US
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Telephone | 212-561-5303
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Fax | 646-652-8190
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Authorized Official
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Title or Position | BILLIER
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Name | INNA KRIMAN
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Credential |
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Telephone | 212-561-5303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 051839-1
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License Number State | NY
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