Provider Demographics
NPI:1386336709
Name:BCT DENTAL PLLC
Entity type:Organization
Organization Name:BCT DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BIANA
Authorized Official - Middle Name:CHANNEL
Authorized Official - Last Name:TATARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-781-3393
Mailing Address - Street 1:310 W 97TH ST APT 41
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6127
Mailing Address - Country:US
Mailing Address - Phone:718-781-3393
Mailing Address - Fax:
Practice Address - Street 1:370 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-4245
Practice Address - Country:US
Practice Address - Phone:718-781-3393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty