Provider Demographics
NPI:1770049298
Name:DOWNTOWN BK DENTAL PLLC
Entity type:Organization
Organization Name:DOWNTOWN BK DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDDON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-403-0447
Mailing Address - Street 1:177 LIVINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-7000
Mailing Address - Country:US
Mailing Address - Phone:718-403-0447
Mailing Address - Fax:
Practice Address - Street 1:177 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-7000
Practice Address - Country:US
Practice Address - Phone:718-403-0447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental