| Knickerbocker Family Dental Center Pc | |
|
214 Stanhope St Brooklyn NY 11237-4202 | |
| (718) 574-0527 | |
| (718) 715-0624 |
| Full Name | Knickerbocker Family Dental Center Pc |
|---|---|
| Speciality | Dentist |
| Location | 214 Stanhope St, Brooklyn, New York |
| Authorized Official Name and Position | Larry D Jacobs (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 7185740527 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Knickerbocker Family Dental Center Pc 214 Stanhope St Brooklyn NY 11237-4202 Ph: (718) 574-0527 | Knickerbocker Family Dental Center Pc 214 Stanhope St Brooklyn NY 11237-4202 Ph: (718) 574-0527 |
| NPI Number | 1861521262 |
|---|---|
| Provider Enumeration Date | 03/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861521262 | NPI | - | NPPES |
| 037914 | Other | NY | NYS DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 039714 (New York) | Primary |
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