Provider Demographics
NPI:1245767680
Name:AM DENTAL ARTS P.C.
Entity Type:Organization
Organization Name:AM DENTAL ARTS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MALKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-524-4222
Mailing Address - Street 1:1415 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3935
Mailing Address - Country:US
Mailing Address - Phone:347-524-4222
Mailing Address - Fax:
Practice Address - Street 1:1415 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3935
Practice Address - Country:US
Practice Address - Phone:347-524-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty