Provider Demographics
NPI:1598968091
Name:LLM DENTAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:LLM DENTAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARALYN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-581-2442
Mailing Address - Street 1:1 ROCKEFELLER PLZ
Mailing Address - Street 2:SUITE 2223
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10020-2003
Mailing Address - Country:US
Mailing Address - Phone:212-581-2442
Mailing Address - Fax:212-581-3051
Practice Address - Street 1:1 ROCKEFELLER PLZ
Practice Address - Street 2:SUITE 2223
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10020-2003
Practice Address - Country:US
Practice Address - Phone:212-581-2442
Practice Address - Fax:212-581-3051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty