Provider Demographics
NPI:1194272831
Name:QUENTIN SMILE DENTAL SERVICES P.C.
Entity type:Organization
Organization Name:QUENTIN SMILE DENTAL SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KHABENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-339-8852
Mailing Address - Street 1:2148 OCEAN AVE
Mailing Address - Street 2:STE.401
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1406
Mailing Address - Country:US
Mailing Address - Phone:718-339-8852
Mailing Address - Fax:
Practice Address - Street 1:2148 OCEAN AVE
Practice Address - Street 2:STE.401
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1406
Practice Address - Country:US
Practice Address - Phone:718-339-8852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty