| Fort Greene Pediatric Dental | |
|
55 Greene Avenue Suite C Brooklyn NY 11238 | |
| (718) 230-7676 | |
| (718) 230-7776 |
| Full Name | Fort Greene Pediatric Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 55 Greene Avenue, Brooklyn, New York |
| Authorized Official Name and Position | Untray Tyrone Brown (PEDIATRIC DENTIST) |
| Authorized Official Contact | 7182307676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Greene Pediatric Dental 55 Greene Avenue Suite C Brooklyn NY 11238 Ph: (718) 230-7676 | Fort Greene Pediatric Dental 55 Greene Avenue Suite C Brooklyn NY 11238 Ph: (718) 230-7676 |
| NPI Number | 1154592004 |
|---|---|
| Provider Enumeration Date | 03/19/2008 |
| Last Update Date | 03/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154592004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 046243 (New York) | Primary |
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