Provider Demographics
NPI:1659144798
Name:SIG DENTAL GROUP PLLC
Entity Type:Organization
Organization Name:SIG DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GELFAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-584-7776
Mailing Address - Street 1:22 MONTANA PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6913
Mailing Address - Country:US
Mailing Address - Phone:917-584-7776
Mailing Address - Fax:
Practice Address - Street 1:2167A RALPH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5405
Practice Address - Country:US
Practice Address - Phone:718-871-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty