EXECUTIVE DENTAL CARE PC
Managed Care Organizations in Brooklyn, NY

License number
New York 036639
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: DR. JAMES M WALLETT D.D.S.
Title: GENERAL DENTIST/OWNER
Phone: (718) 748-6847
Address
Address
8011 Fifth Ave FLOOR 2ND, Brooklyn, NY 11209
National Provider ID: 1073788717
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EXECUTIVE DENTAL CARE, PC

Brooklyn, NY

Industry:
Dentist's Office
Doing business as:
Executive Dental Care P C
Registration:
Mar 29, 2005
Phone:
(718) 748-6847 (Phone)
Addresses:
8011 5 Ave, Brooklyn, NY 11209 (Physical)
PO Box 90507, Brooklyn, NY 11209
State ID:
3183958
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Family And General Dentistry, General Dentist/owner, Owner, President:
James M. Wallett (Family And General Dentistry, General Dentist/owner, Owner, President)
Categories:
Dentists

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