NPI 1073788717

Executive Dental Care PC

Organisation Preferred Provider Organization Brooklyn, NY

Practice location

Address: 8011 Fifth Avenue 2nd Floor, Brooklyn, NY 11209
Phone: (718) 748-6847

Authorised official

Name: James M Wallett
Title: General Dentist/Owner
Phone: (718) 748-6847

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 036639 (NY)

Other Preferred Provider Organization providers in New York →

Registry record

NPI: 1073788717
Entity type: Organization
NPI issued: 24 Apr 2008
Record last updated: 24 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.