Provider Demographics
NPI:1528231214
Name:TAFT'S DENTAL P.C.
Entity Type:Organization
Organization Name:TAFT'S DENTAL P.C.
Other - Org Name:ARVERNE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYUBA
Authorized Official - Middle Name:I
Authorized Official - Last Name:TAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-945-9500
Mailing Address - Street 1:324 BEACH 59TH ST
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1642
Mailing Address - Country:US
Mailing Address - Phone:718-945-9500
Mailing Address - Fax:718-945-6302
Practice Address - Street 1:324 BEACH 59TH ST
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1642
Practice Address - Country:US
Practice Address - Phone:718-945-9500
Practice Address - Fax:718-945-6302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049791122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty