Provider Demographics
NPI:1528218567
Name:COMFORT DENTAL CARE PLLC
Entity Type:Organization
Organization Name:COMFORT DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-826-9045
Mailing Address - Street 1:591 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-4727
Mailing Address - Country:US
Mailing Address - Phone:718-901-7555
Mailing Address - Fax:718-901-7556
Practice Address - Street 1:591 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4727
Practice Address - Country:US
Practice Address - Phone:718-901-7555
Practice Address - Fax:718-901-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0529711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02799291Medicaid