| Dentist 4 U | |
|
186 Broadway Port Ewen NY 12466 | |
| (845) 331-9150 | |
| (845) 331-8846 |
| Full Name | Dentist 4 U |
|---|---|
| Speciality | Dentist |
| Location | 186 Broadway, Port Ewen, New York |
| Authorized Official Name and Position | Irina Lopatnyuk (PRESIDENT) |
| Authorized Official Contact | 8453319150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentist 4 U 58 Jefferson St Highland Mills NY 10930-2726 Ph: (845) 928-4723 | Dentist 4 U 186 Broadway Port Ewen NY 12466 Ph: (845) 331-9150 |
| NPI Number | 1154512655 |
|---|---|
| Provider Enumeration Date | 08/08/2007 |
| Last Update Date | 08/08/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154512655 | NPI | - | NPPES |
| 02382396 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 044997-1 (New York) | Primary |
Hudson Valley Dentist 4u Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 186 Broadway, Port Ewen, NY 12466 Phone: 845-331-9150 Fax: 718-851-0240 |