Provider Demographics
NPI:1457753188
Name:CITIDENTALGROUP38, LLC
Entity Type:Organization
Organization Name:CITIDENTALGROUP38, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-369-8356
Mailing Address - Street 1:18 E. 38TH STREET
Mailing Address - Street 2:12TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:646-369-8356
Mailing Address - Fax:646-514-4106
Practice Address - Street 1:18 E 38TH ST 12 FL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-537-7395
Practice Address - Fax:646-514-4106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty