Provider Demographics
NPI:1487387353
Name:IMPLANT DENTAL WORKS P.L.L.C.
Entity type:Organization
Organization Name:IMPLANT DENTAL WORKS P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:267-469-0016
Mailing Address - Street 1:340 W 28TH ST APT 9J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4741
Mailing Address - Country:US
Mailing Address - Phone:267-469-0016
Mailing Address - Fax:
Practice Address - Street 1:30 E 40TH ST RM 608
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1243
Practice Address - Country:US
Practice Address - Phone:267-469-0016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental