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NPI Code Detail

MEDICARE: READY SMILE DENTAL PC

MEDICARE: READY SMILE DENTAL 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
1122300000XDentist

General Provider Information

NPI Number : 1952141723
Entity Type Code : Organization
Provider Name (Legal Business Name) : READY SMILE DENTAL PC
Provider Business Mailing Address
First Line : 1502 E 14TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-7283
Country : US
Telephone Number : 718-709-4611
Fax Number :
Provider Business Practice Location Address
First Line : 1502 E 14TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-7283
Country : US
Telephone Number : 718-709-4611
Fax Number :
Authorized Official
Title or Position : OWNER
Name : NADIA POUSTOVOIT
Credential : MD
Telephone Number : 718-709-4611
Provider Enumeration Date : 05/29/2024
Last Update Date : 05/29/2024

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Directions to “READY SMILE DENTAL PC ” Practice Location

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