Provider Demographics
NPI:1801920038
Name:ALBERT, DAVID A (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:ALBERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 OLD POND RD
Mailing Address - Street 2:GREAT NECK
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1032
Mailing Address - Country:US
Mailing Address - Phone:917-921-6558
Mailing Address - Fax:
Practice Address - Street 1:99 FORT WASHINGTON AVE
Practice Address - Street 2:AMBULATORY CARE PRACTICE-FIRST FLOOR NYPH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4655
Practice Address - Country:US
Practice Address - Phone:212-342-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038767-11223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health