Provider Demographics
NPI:1609500529
Name:MOBILE DENTAL ANESTHESIOLOGY OF NEW YORK PC
Entity Type:Organization
Organization Name:MOBILE DENTAL ANESTHESIOLOGY OF NEW YORK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PFEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-218-0735
Mailing Address - Street 1:783 BUNKER RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3532
Mailing Address - Country:US
Mailing Address - Phone:516-662-2810
Mailing Address - Fax:
Practice Address - Street 1:783 BUNKER RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-3532
Practice Address - Country:US
Practice Address - Phone:516-662-2810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDentist AnesthesiologistGroup - Single Specialty