Provider Demographics
NPI:1750537718
Name:ACE DENTISTRY PC
Entity type:Organization
Organization Name:ACE DENTISTRY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-497-7710
Mailing Address - Street 1:130 POST AVE
Mailing Address - Street 2:UNIT 3
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3283
Mailing Address - Country:US
Mailing Address - Phone:917-497-7710
Mailing Address - Fax:516-280-6028
Practice Address - Street 1:130 POST AVE
Practice Address - Street 2:UNIT# 3
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-3283
Practice Address - Country:US
Practice Address - Phone:917-497-7710
Practice Address - Fax:516-280-6028
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACE DENTISTRY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-11
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052517-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty