Provider Demographics
NPI:1568908648
Name:HARLEM DENTAL CARE PLLC
Entity Type:Organization
Organization Name:HARLEM DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENRAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHCHEGLOV
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-281-9200
Mailing Address - Street 1:163 W 145TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-4234
Mailing Address - Country:US
Mailing Address - Phone:212-281-9200
Mailing Address - Fax:
Practice Address - Street 1:163 W 145TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-4234
Practice Address - Country:US
Practice Address - Phone:212-281-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0520941122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty