Glad Dental P.c.

NPI #1548558836 in Bronx, New York

Provider Information

NPI Number: 1548558836
Entity Type: Organization
Organization Name: Glad Dental P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 20, 2011
Last Updated: Jul 20, 2011

Practice Location

Address: 293 E 149TH ST
City: Bronx
State: New York
ZIP Code: 10451-5601
Phone: (646) 404-5005

Authorized Official

Name: DR. LIA DATIKASHVILI, D.D.S.
Title: PRESIDENT
Phone: (646) 404-5005

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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