Organization
SMILE ON SOUTH BROADWAY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADOM CREW (PRESIDENT)
(914) 378-8123
Entity
Organization
Contact information
Practice address
107 S BROADWAY, YONKERS, NY 10701-4006
(914) 378-8123
Mailing address
107 S BROADWAY, YONKERS, NY 10701-4006
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/16/2016
Last updated
07/16/2016
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