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General NPI Number Information
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NPI Number | 1922149962
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Entity Type | Organization
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Legal Business Name | COORDINATED DENTAL, P.C.
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Dates
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Enumeration Date | 02/11/2007
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 515 MADISON AVE SUITE 1225
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City | NEW YORK
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State | NY
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Zip | 10022-5403
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Country | US
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Telephone | 212-888-3159
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Fax |
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Provider Business Mailing Address
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Address Line | 515 MADISON AVE SUITE 1225
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City | NEW YORK
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State | NY
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Zip | 10022-5403
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Country | US
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Telephone | 212-888-3159
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD K APPELLE
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Credential | D.M.D.
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Telephone | 212-888-3159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 050064
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 024608
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License Number State | NY
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