| Chenango Bridge Dental, Pllc | |
|
528 Main St. Chenango Bridge NY 13745 | |
| (607) 648-4113 | |
| Not Available |
| Full Name | Chenango Bridge Dental, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 528 Main St., Chenango Bridge, New York |
| Authorized Official Name and Position | Stanley S Romanowski (OWNER) |
| Authorized Official Contact | 6076484113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chenango Bridge Dental, Pllc Po Box 481 Chenango Bridge NY 13745-0481 Ph: (607) 648-4113 | Chenango Bridge Dental, Pllc 528 Main St. Chenango Bridge NY 13745 Ph: (607) 648-4113 |
| NPI Number | 1730397084 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730397084 | NPI | - | NPPES |
| 02244806 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 042233 (New York) | Primary |