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General NPI Number Information
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NPI Number | 1952686073
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Entity Type | Organization
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Legal Business Name | ATLAS PARK DENTAL, P.C.
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 8028 COOPER AVE BUILDING 6 SUITE 207
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City | GLENDALE
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State | NY
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Zip | 11385-7711
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Country | US
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Telephone | 718-894-2110
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Fax |
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Provider Business Mailing Address
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Address Line | 8028 COOPER AVE BUILDING 6 SUITE 207
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City | GLENDALE
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State | NY
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Zip | 11385-7711
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Country | US
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Telephone | 718-894-2110
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JULIA TURANSKY
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Credential |
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Telephone | 718-894-2110
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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 | 054307
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 054485
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 055500
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 049105
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 055514
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 048889
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License Number State | NY
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