Provider Demographics
NPI:1023699022
Name:DENTAL HOUSE PLLC
Entity type:Organization
Organization Name:DENTAL HOUSE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SOFIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRASILNIKOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-888-3384
Mailing Address - Street 1:41 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6601
Mailing Address - Country:US
Mailing Address - Phone:212-888-3384
Mailing Address - Fax:646-960-7940
Practice Address - Street 1:41 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6601
Practice Address - Country:US
Practice Address - Phone:212-888-3384
Practice Address - Fax:646-960-7940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty