| Brewerton Family Dentistry | |
|
5501 Bartel Rd Brewerton NY 13029-8701 | |
| (315) 676-2209 | |
| (315) 676-2247 |
| Full Name | Brewerton Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 5501 Bartel Rd, Brewerton, New York |
| Authorized Official Name and Position | Imadeh R Nosegbe (OWNER) |
| Authorized Official Contact | 3156762209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brewerton Family Dentistry Po Box 830 Brewerton NY 13029-0830 Ph: (315) 676-2209 | Brewerton Family Dentistry 5501 Bartel Rd Brewerton NY 13029-8701 Ph: (315) 676-2209 |
| NPI Number | 1164553079 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164553079 | NPI | - | NPPES |
| 02570547 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 051614 (New York) | Primary |
Mccue Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9651 Brewerton Rd, Brewerton, NY 13029 Phone: 315-676-7900 Fax: 315-785-1080 | |
Timothy Okeefe Md Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5501 Bartel Rd, Brewerton, NY 13029 Phone: 315-603-3795 |