| Family Dental Practice | |
|
503 S Broadway Ste 250 Yonkers NY 10705-6202 | |
| (914) 376-4033 | |
| (914) 376-4035 |
| Full Name | Family Dental Practice |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 503 S Broadway Ste 250, Yonkers, New York |
| Authorized Official Name and Position | Joon S. Lee (PRESIDENT) |
| Authorized Official Contact | 9143764033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Practice 503 S Broadway Ste 250 Yonkers NY 10705-6202 Ph: (914) 376-4033 | Family Dental Practice 503 S Broadway Ste 250 Yonkers NY 10705-6202 Ph: (914) 376-4033 |
| NPI Number | 1578715629 |
|---|---|
| Provider Enumeration Date | 10/21/2008 |
| Last Update Date | 10/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578715629 | NPI | - | NPPES |
| 1003006529 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 050790 (New York) | Primary |
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