Provider Demographics
NPI:1457092876
Name:KRASNOW, BETZALEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:BETZALEL
Middle Name:
Last Name:KRASNOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-2630
Mailing Address - Country:US
Mailing Address - Phone:718-603-9093
Mailing Address - Fax:
Practice Address - Street 1:549 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-2630
Practice Address - Country:US
Practice Address - Phone:718-603-9093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063212122300000X, 1223G0001X
FLDN276311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist