| Fordham Dental Care, P.c. | |
|
573 E Fordham Rd Store Front Bronx NY 10458-5018 | |
| (917) 962-9990 | |
| (917) 962-9992 |
| Full Name | Fordham Dental Care, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 573 E Fordham Rd, Bronx, New York |
| Authorized Official Name and Position | Hyeong Chan Kim (PRESIDENT) |
| Authorized Official Contact | 9179629990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fordham Dental Care, P.c. 573 E Fordham Rd Store Front Bronx NY 10458-5018 Ph: (917) 962-9990 | Fordham Dental Care, P.c. 573 E Fordham Rd Store Front Bronx NY 10458-5018 Ph: (917) 962-9990 |
| NPI Number | 1205177292 |
|---|---|
| Provider Enumeration Date | 03/15/2013 |
| Last Update Date | 03/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205177292 | NPI | - | NPPES |
| 03463949 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 055881-1 (New York) | Primary |
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