| Grant Blvd Dental Pllc | |
|
1500 Grant Blvd Syracuse NY 13208 | |
| (315) 472-3414 | |
| Not Available |
| Full Name | Grant Blvd Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1500 Grant Blvd, Syracuse, New York |
| Authorized Official Name and Position | Juan C Kassab (OWNER DENTIST) |
| Authorized Official Contact | 3154723414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant Blvd Dental Pllc 118 S Main St Canastota NY 13032-1234 Ph: (315) 697-9287 | Grant Blvd Dental Pllc 1500 Grant Blvd Syracuse NY 13208 Ph: (315) 472-3414 |
| NPI Number | 1982729091 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982729091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0443351 (New York) | Primary |
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