| Citywide Dental Family Practice, Pllc | |
|
384 E 149th St Suite 216 Bronx NY 10455-3908 | |
| (718) 993-7788 | |
| Not Available |
| Full Name | Citywide Dental Family Practice, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 384 E 149th St, Bronx, New York |
| Authorized Official Name and Position | Janice L Perez (CEO) |
| Authorized Official Contact | 7189937788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Citywide Dental Family Practice, Pllc 384 E 149th St Suite 216 Bronx NY 10455-3908 Ph: (718) 993-7788 | Citywide Dental Family Practice, Pllc 384 E 149th St Suite 216 Bronx NY 10455-3908 Ph: (718) 993-7788 |
| NPI Number | 1093985624 |
|---|---|
| Provider Enumeration Date | 03/11/2008 |
| Last Update Date | 03/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093985624 | NPI | - | NPPES |
| 02363519 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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