| East 4th Street Dental Pllc | |
|
101 East 4th Street New York NY 10003 | |
| (212) 239-7027 | |
| Not Available |
| Full Name | East 4th Street Dental Pllc |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 101 East 4th Street, New York, New York |
| Authorized Official Name and Position | Dmitriy Volotsenko (MANAGING MEMBER) |
| Authorized Official Contact | 9177978052 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East 4th Street Dental Pllc 101 East 4th Street New York NY 10003 Ph: (212) 239-7027 | East 4th Street Dental Pllc 101 East 4th Street New York NY 10003 Ph: (212) 239-7027 |
| NPI Number | 1205490182 |
|---|---|
| Provider Enumeration Date | 04/26/2019 |
| Last Update Date | 04/26/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205490182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |
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