| Park Avenue Dental Anesthesia Services Pc | |
|
563 Park Ave New York NY 10065-7379 | |
| (212) 808-0090 | |
| (212) 935-1296 |
| Full Name | Park Avenue Dental Anesthesia Services Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 563 Park Ave, New York, New York |
| Authorized Official Name and Position | Gregory C Chotkowski (OWNER) |
| Authorized Official Contact | 2128380090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Avenue Dental Anesthesia Services Pc 563 Park Ave New York NY 10065-7379 Ph: (212) 808-0090 | Park Avenue Dental Anesthesia Services Pc 563 Park Ave New York NY 10065-7379 Ph: (212) 808-0090 |
| NPI Number | 1154741049 |
|---|---|
| Provider Enumeration Date | 04/18/2014 |
| Last Update Date | 04/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154741049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0417231 (New York) | Primary |
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