Provider Demographics
NPI:1811268774
Name:THE OFFICE FOR DENTAL ARTS, P.C.
Entity type:Organization
Organization Name:THE OFFICE FOR DENTAL ARTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:HERSHKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-468-3434
Mailing Address - Street 1:22424 UNION TPKE STE 1M
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3650
Mailing Address - Country:US
Mailing Address - Phone:718-468-3434
Mailing Address - Fax:718-465-7576
Practice Address - Street 1:22424 UNION TPKE STE 1M
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11364-3650
Practice Address - Country:US
Practice Address - Phone:718-468-3434
Practice Address - Fax:718-465-7576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty