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Serena Kassam
Pediatric Dentist in New York, New York
NPI 1699978924

Serena Kassam is a Pediatric Dentist based in North Providence, NY and is specialized in Pediatric Dentistry. Serena Kassam practices in New York, NY. The NPI Number for Serena Kassam is 1699978924 and holds a License No. LD00017 (New York).

The current practice location address for Serena Kassam is 345 E 24Th St # 9W, New York, NY and can be reached out via phone at 617-699-8465. You can also correspond with Serena Kassam through the mailing address at 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI - 02904-5113 (mailing address contact number: 401-456-3309).

Location: 345 E 24Th St # 9W, New York, NY, 02904-5113
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Provider Profile Details
NPI Number
1699978924
Provider Name
Serena Kassam
Credential
Provider Entity Type
Individual
Gender
Female
Address
345 E 24Th St # 9W, New York, NY, 02904-5113
Phone Number
617-699-8465
Fax Number
Provider Enumeration Date
06/06/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
056467 01 NY NYS DENTAL LICENSE
LD00017 01 RI LIMITED LICENSE
institution
Provider Business Practice Location Address Details
Address
345 E 24Th St # 9W
City
State
Zip
10010-4020
Phone Number
617-699-8465
Fax Number
person
Provider Business Mailing Address Details
Address
345 E 24Th St # 9W
City
State
Zip
10010-4020
Phone Number
617-699-8465
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
LD00017 (Rhode Island)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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