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General NPI Number Information
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NPI Number | 1902946833
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Entity Type | Organization
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Legal Business Name | 30 CPS DENTAL, PLLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 30 CENTRAL PARK S 9TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-1628
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Country | US
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Telephone | 212-319-5002
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Fax | 212-319-3064
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Provider Business Mailing Address
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Address Line | 30 CENTRAL PARK S 9TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-1628
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Country | US
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Telephone | 212-319-5002
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Fax | 212-319-3064
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALAIN ROIZEN
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Credential | D.D.S, M.S.
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Telephone | 212-319-5002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 032045-1
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License Number State | NY
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