Brewerton Family Dentistry in Brewerton - Dentist
Brewerton Family Dentistry - NPI 1164553079
Brewerton Family Dentistry is a Dentist in Brewerton, New York. Brewerton Family Dentistry practices all healthcare services and medical treatments related to Dentist. The NPI Number for Brewerton Family Dentistry is 1164553079. The last update date is 2020-08-22.
Brewerton Family Dentistry's current location address is Po Box 830, Brewerton, New York. You can contact this provider via phone number 3156762209 and fax number 3156762247. The mailing address for Brewerton Family Dentistry is Po Box 830, Brewerton, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Brewerton Family Dentistry |
|---|---|
| Address | Po Box 830, Brewerton, New York |
| Phone Number | 3156762209 |
| Fax Number | 3156762247 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Nosegbe R Imadeh |
| Credentials | DMD |
| Telephone Number | 3156762209 |
NPI Number Detail
| NPI Number | 1164553079 |
|---|---|
| Provider Enumeration Date | 2007-03-09 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | Po Box 830 |
|---|---|
| City | Brewerton |
| State | New York (NY) |
| Post Code | 130290830 |
| Phone Number | 3156762209 |
| Fax Number | 3156762247 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 51614 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2570547 | NY | -- |
Post Comment/ Review Below
What is the Brewerton Family Dentistry's unique identification number?
The Brewerton Family Dentistry has been assigned the NPI (National Provider Identifier) Number 1164553079 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Brewerton Family Dentistry is physically located?
The Brewerton Family Dentistry is situated at the following address: Po Box 830, Brewerton, NY 130290830.
What is the Brewerton Family Dentistry's specialty and taxonomy code?
The Brewerton Family Dentistry's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
When did the Brewerton Family Dentistry receive its 1164553079?
The Brewerton Family Dentistry was issued its 1164553079 on 2007-03-09, which is the date when the organization was assigned this unique identifier.
When was the information pertaining to Brewerton Family Dentistry most recently updated or revised?
The details related to Brewerton Family Dentistry, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.