Provider Demographics
NPI:1417321126
Name:741 DENTAL PC
Entity Type:Organization
Organization Name:741 DENTAL PC
Other - Org Name:ELITE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLAPIETRA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-218-6888
Mailing Address - Street 1:741 FLUSHING AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4419
Mailing Address - Country:US
Mailing Address - Phone:718-963-9500
Mailing Address - Fax:718-228-6818
Practice Address - Street 1:741 FLUSHING AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-218-6888
Practice Address - Fax:718-228-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty