| NPI | 1275606865 |
|---|---|
| Former Legal Business Name | MATTHEW NEARY DDS & JOHN LANZETTA DMD PC |
| Doing Business As | MADISON AVENUE PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | JENNY GARCIA-ROCHA Sr Credentialing Team Lead 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 047299) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 35077) |
| 122300000X Dentist (Licence: NY 041733) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-09-18 |