| Pine Bush Dental Group | |
|
2412 Route 52 Pine Bush NY 12566-7037 | |
| (845) 744-5422 | |
| Not Available |
| Full Name | Pine Bush Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2412 Route 52, Pine Bush, New York |
| Authorized Official Name and Position | Marc Faber (OWNER/DDS) |
| Authorized Official Contact | 8457445422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Bush Dental Group 809 State Route 208 Monroe NY 10950-1829 Ph: (845) 782-5040 | Pine Bush Dental Group 2412 Route 52 Pine Bush NY 12566-7037 Ph: (845) 744-5422 |
| NPI Number | 1588104376 |
|---|---|
| Provider Enumeration Date | 02/28/2017 |
| Last Update Date | 02/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588104376 | NPI | - | NPPES |
| 3399442 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 055718 (New York) | Primary |
Maple Ave. Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Maple Ave, Pine Bush, NY 12566 Phone: 845-744-5570 |