Provider Demographics
NPI:1043503949
Name:ARCH DENTAL ASSOCIATES
Entity type:Organization
Organization Name:ARCH DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-683-1870
Mailing Address - Street 1:3 WASHINGTON SQUARE VLG
Mailing Address - Street 2:SUITE 1B/D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1836
Mailing Address - Country:US
Mailing Address - Phone:212-477-4330
Mailing Address - Fax:
Practice Address - Street 1:3 WASHINGTON SQUARE VLG
Practice Address - Street 2:SUITE 1B/D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1836
Practice Address - Country:US
Practice Address - Phone:212-477-4330
Practice Address - Fax:212-674-2290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty