| Periodontics Of New York, Pllc | |
|
30 E 40th St Rm 1102 New York NY 10016-1204 | |
| (212) 683-4476 | |
| (212) 683-4577 |
| Full Name | Periodontics Of New York, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 30 E 40th St Rm 1102, New York, New York |
| Authorized Official Name and Position | Philip David Pack (OWNER) |
| Authorized Official Contact | 2126834476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Periodontics Of New York, Pllc 30 E 40th St Rm 1102 New York NY 10016-1204 Ph: (212) 683-4476 | Periodontics Of New York, Pllc 30 E 40th St Rm 1102 New York NY 10016-1204 Ph: (212) 683-4476 |
| NPI Number | 1992504856 |
|---|---|
| Provider Enumeration Date | 03/12/2025 |
| Last Update Date | 03/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992504856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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