Provider Demographics
NPI:1801107347
Name:CENTRAL PARK PERIODONTICS, P.C.
Entity type:Organization
Organization Name:CENTRAL PARK PERIODONTICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENBT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-355-5595
Mailing Address - Street 1:40 CENTRAL PARK S
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1633
Mailing Address - Country:US
Mailing Address - Phone:212-355-5595
Mailing Address - Fax:212-355-5596
Practice Address - Street 1:40 CENTRAL PARK S
Practice Address - Street 2:SUITE 2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1633
Practice Address - Country:US
Practice Address - Phone:212-355-5595
Practice Address - Fax:212-355-5596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0303061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty