Provider Demographics
NPI:1588983738
Name:LALABA DENTAL PC
Entity type:Organization
Organization Name:LALABA DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITA
Authorized Official - Middle Name:SHARAD
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-365-3701
Mailing Address - Street 1:2 WOODLAND CT
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1432
Mailing Address - Country:US
Mailing Address - Phone:516-365-3701
Mailing Address - Fax:516-365-3701
Practice Address - Street 1:679 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-3307
Practice Address - Country:US
Practice Address - Phone:718-665-6065
Practice Address - Fax:718-665-6065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental