Organization · NPI-2

573 Fordham Dental PC

Dentist, General Practice · Bronx, NY

NPI number1043634660
StatusActive
Last updated in NPPESFeb 18, 2014

Details

NPI
1043634660
Entity type
Organization (NPI-2)
Legal business name
573 Fordham Dental PC
Organization subpart
No
Enumeration date
Feb 18, 2014
Last updated
Feb 18, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice––Yes

Practice location

573 E Fordham Rd
Bronx, NY 10458-5018

Phone 917-962-9990

Mailing address

573 E Fordham Rd
Bronx, NY 10458-5018

Authorized official

Nina Otano
Office Manager
9179629990

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist, General Practice providers in Bronx, NY