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12TH STREET DENTAL PLLC

Dental Public Health

New York, New York

Provider NPI: 1013499052

Organization Information:
Organization Name:  12TH STREET DENTAL PLLC
Organization is not Subpart
Authorized Official:  DAVID  JANASH  PRESIDENT AND CEO  917-9154504

Practice Location:
77 E 12TH ST  NEW YORK, NY 10003 US
Tel: 917-915-4504  Fax: --

Business Mailing Address:
30 CENTRAL PARK S RM 13C  NEW YORK, NY 10019 US
Tel: 212-355-2000  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223D0001XDental Providers
Dentist
Dental Public Health
NY051610





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