# SIRECI FAMILY DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033354543
- **Authorized official:** DR. EDWARD M SIRECI DDS (PRESIDENT)
- **Authorized official phone:** (718) 829-0455

## Contact information

- **Practice address:** 2861 BRUCKNER BLVD, BRONX, NY 10465-1965
- **Practice address phone:** (718) 829-0455
- **Practice address fax:** (718) 829-0825
- **Mailing address:** 2861 BRUCKNER BLVD, BRONX, NY 10465-1965
- **Mailing address phone:** (718) 829-0455
- **Mailing address fax:** (718) 829-0825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 036511 | NY | Yes |

## Other

- **Enumeration date:** 12/12/2008
- **Last updated:** 12/12/2008