| Dr. Brian Ketover Dmd Llc | |
|
580 5th Ave Brooklyn NY 11215-5436 | |
| (718) 768-8400 | |
| (718) 768-7450 |
| Full Name | Dr. Brian Ketover Dmd Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 580 5th Ave, Brooklyn, New York |
| Authorized Official Name and Position | Brian Ketover (DENTIST) |
| Authorized Official Contact | 7181688400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Brian Ketover Dmd Llc 580 5th Ave Brooklyn NY 11215-5436 Ph: (718) 768-8400 | Dr. Brian Ketover Dmd Llc 580 5th Ave Brooklyn NY 11215-5436 Ph: (718) 768-8400 |
| NPI Number | 1710275987 |
|---|---|
| Provider Enumeration Date | 07/21/2011 |
| Last Update Date | 07/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710275987 | NPI | - | NPPES |
| 00532958 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 035400 (New York) | Primary |
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