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Organization
BROOKSIDE FAMILY DENTAL CORP
Active
Organization
BROOKSIDE FAMILY DENTAL CORP
Active
Other names
Brookside Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KINDA HANNA YACOUB (DDS)
(973) 566-6161
Entity
Organization
Contact information
Practice address
399 HOOVER AVE, SUITE 1, BLOOMFIELD, NJ 07003
(973) 566-6161
(973) 566-0866
Mailing address
399 HOOVER AVE, SUITE 1, BLOOMFIELD, NJ 07003
(973) 566-6161
(973) 566-0866
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1020914
NJ
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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