Provider Demographics
NPI:1457612764
Name:EMPIRE DENTAL CARE P.C.
Entity Type:Organization
Organization Name:EMPIRE DENTAL CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:V
Authorized Official - Last Name:KATAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-294-8800
Mailing Address - Street 1:1963 GRAND CONCOURSE
Mailing Address - Street 2:SUITE LL
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4994
Mailing Address - Country:US
Mailing Address - Phone:718-294-8800
Mailing Address - Fax:718-294-1590
Practice Address - Street 1:1963 GRAND CONCOURSE
Practice Address - Street 2:SUITE LL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4994
Practice Address - Country:US
Practice Address - Phone:718-294-8800
Practice Address - Fax:718-294-1590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty