Provider Demographics
NPI:1639250541
Name:FIRST CLASS FAMILY DENTISTRY OF NEW YORK LLC
Entity Type:Organization
Organization Name:FIRST CLASS FAMILY DENTISTRY OF NEW YORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDULESCU
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE M,ANAGER
Authorized Official - Phone:516-581-6624
Mailing Address - Street 1:608 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10020-2303
Mailing Address - Country:US
Mailing Address - Phone:212-245-5817
Mailing Address - Fax:212-664-1950
Practice Address - Street 1:608 5TH AVE STE 808
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10020-2303
Practice Address - Country:US
Practice Address - Phone:212-245-5817
Practice Address - Fax:212-664-1950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty