573 Fordham Dental PC

NPI #1043634660 in Bronx, New York

Provider Information

NPI Number: 1043634660
Entity Type: Organization
Organization Name: 573 Fordham Dental PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 18, 2014
Last Updated: Feb 18, 2014

Practice Location

Address: 573 E FORDHAM RD
City: Bronx
State: New York
ZIP Code: 10458-5018
Phone: (917) 962-9990

Authorized Official

Name: NINA OTANO
Title: OFFICE MANAGER
Phone: (917) 962-9990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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