Bertha D. Bravo Dentist Pc | |
362 W Old Country Rd Hicksville NY 11801-4113 | |
(516) 933-3000 | |
(516) 933-3001 |
Full Name | Bertha D. Bravo Dentist Pc |
---|---|
Speciality | Dentist - General Practice |
Location | 362 W Old Country Rd, Hicksville, New York |
Authorized Official Name and Position | Bertha Dina Bravo (DENTIST) |
Authorized Official Contact | 5169333000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Bertha D. Bravo Dentist Pc 362 W Old Country Rd Hicksville NY 11801-4113 Ph: (516) 933-3000 | Bertha D. Bravo Dentist Pc 362 W Old Country Rd Hicksville NY 11801-4113 Ph: (516) 933-3000 |
NPI Number | 1184896912 |
---|---|
Provider Enumeration Date | 04/01/2008 |
Last Update Date | 02/03/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184896912 | NPI | - | NPPES |
01353584 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 044278 (New York) | Primary |
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