Brewerton Family Dentistry

NPI #1164553079 in Brewerton, New York

Provider Information

NPI Number: 1164553079
Entity Type: Organization
Organization Name: Brewerton Family Dentistry
Primary Specialty: Dentist
Enumeration Date: Mar 9, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 5501 BARTEL RD
City: Brewerton
State: New York
ZIP Code: 13029-8701
Phone: (315) 676-2209

Authorized Official

Name: DR. IMADEH R NOSEGBE, DMD
Title: OWNER
Phone: (315) 676-2209

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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