Provider Demographics
NPI:1164544367
Name:MARK S BRISKIN DDS PC
Entity Type:Organization
Organization Name:MARK S BRISKIN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRISKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-693-1221
Mailing Address - Street 1:547 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2143
Mailing Address - Country:US
Mailing Address - Phone:914-693-1221
Mailing Address - Fax:914-693-0868
Practice Address - Street 1:547 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-2143
Practice Address - Country:US
Practice Address - Phone:914-693-1221
Practice Address - Fax:914-693-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034344261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental