Organization
MONTEFIORE DENTAL DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES BROCKETT (ADMINISTRATOR)
(718) 920-4167
Entity
Organization
Contact information
Practice address
305 E 161ST ST, BRONX, NY 10451-3535
(888) 700-6623
(718) 515-5419
Mailing address
PO BOX 4156, NEW YORK, NY 10261-4156
(718) 920-4168
(718) 515-5419
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/18/2007
Last updated
08/22/2020
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