Your Bronx Dentist

NPI #1184107344 in Bronx, New York

Provider Information

NPI Number: 1184107344
Entity Type: Organization
Organization Name: Your Bronx Dentist
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 12, 2018
Last Updated: Sep 12, 2018

Practice Location

Address: 3310 BAINBRIDGE AVE
City: Bronx
State: New York
ZIP Code: 10467-2856
Phone: (718) 654-3456

Authorized Official

Name: EBBIE BOUTEHSAZ, DDS
Title: PRESIDENT
Phone: (516) 455-6802

Specialties & Taxonomy Codes

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

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