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Organization

MONTEFIORE DENTAL

Active
Other names
BLONDELL DENTAL DEPARTMENT
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES BROCKETT (ADMINISTRATOR)
(718) 920-4167
Entity
Organization

Contact information

Practice address
1575 BLONDELL AVE, FIRST FLOOR, BRONX, NY 10461-2660
(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
11/10/2025
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