| 57 Central Dental Professional Corporation | |
|
57 W 57th St Ste 710 New York NY 10019-2802 | |
| (212) 564-1888 | |
| (212) 564-1161 |
| Full Name | 57 Central Dental Professional Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 57 W 57th St Ste 710, New York, New York |
| Authorized Official Name and Position | Jung-hun Kim (PRESIDENT) |
| Authorized Official Contact | 9174429164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 57 Central Dental Professional Corporation 100 Old Palisade Rd Apt 2705 Fort Lee NJ 07024-7022 Ph: (917) 442-9164 | 57 Central Dental Professional Corporation 57 W 57th St Ste 710 New York NY 10019-2802 Ph: (212) 564-1888 |
| NPI Number | 1134628415 |
|---|---|
| Provider Enumeration Date | 02/01/2018 |
| Last Update Date | 02/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134628415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 051275 (New York) | Primary |
| 1223G0001X | Dentist - General Practice | 051532 (New York) | Secondary |
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