573 Fordham Dental PC

Organization Active NPI General Practice Dentistry · Bronx, NY

NPI 1043634660 · NPPES record last updated Feb 18, 2014

Key facts

NPI
1043634660
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
573 FORDHAM DENTAL PC
Practice address
573 E Fordham Rd
Bronx, NY 10458-5018
Phone
(917) 962-9990
NPI assigned
Feb 18, 2014
Organization subpart
No

Authorized official

Name
Nina Otano
Title
Office Manager
Phone
(917) 962-9990

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

573 E Fordham Rd
Bronx, NY 10458
Phone (917) 496-6032

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

573 E Fordham Rd
Bronx, NY 10458-5018

Mailing address

573 E Fordham Rd
Bronx, NY 10458-5018

Other providers in Bronx, NY

All providers in Bronx, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.