| Concourse West Dental Pllc | |
|
880 River Avenue Bronx NY 10452 | |
| (718) 992-0410 | |
| Not Available |
| Full Name | Concourse West Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 880 River Avenue, Bronx, New York |
| Authorized Official Name and Position | David Magid (MANAGER) |
| Authorized Official Contact | 7189920410 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Concourse West Dental Pllc 880 River Avenue Bronx NY 10452 Ph: () - | Concourse West Dental Pllc 880 River Avenue Bronx NY 10452 Ph: (718) 992-0410 |
| NPI Number | 1902147911 |
|---|---|
| Provider Enumeration Date | 03/15/2013 |
| Last Update Date | 03/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902147911 | NPI | - | NPPES |
| 02408928 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 050404 (New York) | Primary |
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