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Contact Information

4TH AVENUE DENTAL
5404 4TH AVE
BROOKLYN, NY11220-3006
 Phone: 718-439-2876
 Fax: 718-439-2879
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for 4TH AVENUE DENTAL

NPI # 1295009447
LBN Legal business name 4TH AVENUE DENTAL
Authorized official ANDREW MARON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/06/2012
Last updated 03/06/2012 - About 14 years ago
Identifiers
NJ License # 18369
NY License # 027990
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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