| Jerome Dental Pc | |
|
1810 Jerome Ave 2nd Floor Brooklyn NY 11235-3621 | |
| (718) 615-2030 | |
| (718) 615-2030 |
| Full Name | Jerome Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1810 Jerome Ave, Brooklyn, New York |
| Authorized Official Name and Position | Nataliya Gubenko (EXECUTIVE OFFICER) |
| Authorized Official Contact | 7186152030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerome Dental Pc 1810 Jerome Ave 2nd Floor Brooklyn NY 11235-3621 Ph: (718) 615-2030 | Jerome Dental Pc 1810 Jerome Ave 2nd Floor Brooklyn NY 11235-3621 Ph: (718) 615-2030 |
| NPI Number | 1487797338 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 07/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487797338 | NPI | - | NPPES |
| 01663405 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 046347 (New York) | Primary |
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