| Your Bronx Dentist | |
|
3310 Bainbridge Ave Bronx NY 10467-2856 | |
| (718) 654-3456 | |
| Not Available |
| Full Name | Your Bronx Dentist |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3310 Bainbridge Ave, Bronx, New York |
| Authorized Official Name and Position | Ebbie Boutehsaz (PRESIDENT) |
| Authorized Official Contact | 5164556802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Bronx Dentist 3310 Bainbridge Ave Bronx NY 10467-2856 Ph: () - | Your Bronx Dentist 3310 Bainbridge Ave Bronx NY 10467-2856 Ph: (718) 654-3456 |
| NPI Number | 1184107344 |
|---|---|
| Provider Enumeration Date | 09/12/2018 |
| Last Update Date | 09/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184107344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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