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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