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NPI Code Detail

MEDICARE: 7TH AVE DENTAL OFFICE P.C.

MEDICARE: 7TH AVE DENTAL OFFICE P.C.
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
11223G0001XGeneral Practice Dentistry038986NY

General Provider Information

NPI Number : 1619107950
Entity Type Code : Organization
Provider Name (Legal Business Name) : 7TH AVE DENTAL OFFICE P.C.
Provider Business Mailing Address
First Line : 5610 7TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-3510
Country : US
Telephone Number : 718-436-1339
Fax Number : 718-436-1342
Provider Business Practice Location Address
First Line : 5610 7TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-3510
Country : US
Telephone Number : 718-436-1339
Fax Number : 718-436-1342
Authorized Official
Title or Position : MANAGER
Name : ALEX HOLLANDER
Credential :
Telephone Number : 718-436-1339
Provider Enumeration Date : 07/21/2009
Last Update Date : 07/21/2009

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Directions to “7TH AVE DENTAL OFFICE P.C. ” Practice Location

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