Madison Avenue Periodontics, P.c.

NPI #1275606865 in NY, New York

Provider Information

NPI Number: 1275606865
Entity Type: Organization
Organization Name: Madison Avenue Periodontics, P.c.
Primary Specialty: Dentist
Enumeration Date: Nov 15, 2006
Last Updated: Sep 18, 2024

Practice Location

Address: 501 MADISON AVE
Address 2: 22ND FLOOR
City: NY
State: New York
ZIP Code: 10022
Phone: (212) 755-1144

Authorized Official

Name: JENNY GARCIA-ROCHA
Title: SR CREDENTIALING TEAM LEAD
Phone: (972) 869-3789

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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