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General NPI Number Information
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NPI Number | 1881986438
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Entity Type | Organization
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Legal Business Name | KBNY DENTAL PC
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 44 W 10TH ST SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10011-8762
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Country | US
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Telephone | 212-505-0295
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Fax | 888-687-3595
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Provider Business Mailing Address
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Address Line | 44 W 10TH ST SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10011-8762
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Country | US
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Telephone | 212-505-0295
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Fax | 888-687-3595
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATE BRAYMAN
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Credential | D.D.S.
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Telephone | 212-505-0295
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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 | 054908
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License Number State | NY
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