Provider Demographics
NPI:1326290362
Name:HUDSON DENTAL CARE,PLLC
Entity Type:Organization
Organization Name:HUDSON DENTAL CARE,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DYAKIV
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-643-1951
Mailing Address - Street 1:138 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1502
Mailing Address - Country:US
Mailing Address - Phone:646-643-1951
Mailing Address - Fax:
Practice Address - Street 1:75 COOLEY ST
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2933
Practice Address - Country:US
Practice Address - Phone:914-495-3064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0495481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty