Organization
YOUR SYRACUSE FAMILY DENTIST P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH MELUNI DDS (PARTNER/DENTIST)
(315) 477-9960
Entity
Organization
Contact information
Practice address
4627 ONONDAGA BLVD, SYRACUSE, NY 13219-3301
(315) 477-9960
Mailing address
4627 ONONDAGA BLVD, SYRACUSE, NY 13219-3301
(315) 477-9960
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235261173
CMS ISSUED
NY
01
—
1871117184
CMS ISSUED
NY
Enumeration date
08/28/2024
Last updated
08/28/2024
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