# BROOKSIDE FAMILY DENTAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brookside Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053585612
- **Authorized official:** KINDA HANNA YACOUB (DDS)
- **Authorized official phone:** (973) 566-6161

## Contact information

- **Practice address:** 399 HOOVER AVE, SUITE 1, BLOOMFIELD, NJ 07003
- **Practice address phone:** (973) 566-6161
- **Practice address fax:** (973) 566-0866
- **Mailing address:** 399 HOOVER AVE, SUITE 1, BLOOMFIELD, NJ 07003
- **Mailing address phone:** (973) 566-6161
- **Mailing address fax:** (973) 566-0866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D1020914 | NJ | Yes |

## Other

- **Enumeration date:** 04/15/2008
- **Last updated:** 04/15/2008