Provider Demographics
NPI:1760962534
Name:EMPIRE DENTAL AESTHETICS PLLC
Entity Type:Organization
Organization Name:EMPIRE DENTAL AESTHETICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMUNAJED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-521-9308
Mailing Address - Street 1:16 E 52ND ST STE 401
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5306
Mailing Address - Country:US
Mailing Address - Phone:212-393-4650
Mailing Address - Fax:
Practice Address - Street 1:16 E 52ND ST STE 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5306
Practice Address - Country:US
Practice Address - Phone:212-393-4650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty