MEDICARE: UNIQUE DENTAL CARE OF NYC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	045634	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609930239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUE DENTAL CARE OF NYC PC

Provider Business Mailing Address
First Line	:	3436 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-1716
Country	:	US
Telephone Number	:	718-647-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3436 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-1716
Country	:	US
Telephone Number	:	718-647-3700
Fax Number	:	718-235-1811

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ABDULKADER ABUAHAMED
Credential	:
Telephone Number	:	718-647-3700

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	04/27/2012

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