Provider Demographics
NPI:1821411000
Name:CENTER FOR DENTAL IMPLANTS LLC
Entity Type:Organization
Organization Name:CENTER FOR DENTAL IMPLANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-505-6862
Mailing Address - Street 1:30 CENTRAL PARK S
Mailing Address - Street 2:SUITE 11D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1628
Mailing Address - Country:US
Mailing Address - Phone:212-505-6862
Mailing Address - Fax:
Practice Address - Street 1:30 CENTRAL PARK S
Practice Address - Street 2:SUITE 11D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1628
Practice Address - Country:US
Practice Address - Phone:212-505-6862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046646122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty