Organization
GENESIS DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDRES MIRANDA DDS (PRESIDENT)
(718) 584-3826
Entity
Organization
Contact information
Practice address
375 E FORDHAM RD, 2 FLOOR, BRONX, NY 10458-5033
(718) 584-3826
(718) 584-7309
Mailing address
375 E FORDHAM RD, 2 FLOOR, BRONX, NY 10458-5033
(718) 584-3826
(718) 584-7309
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045711-1
NY
Other
Enumeration date
05/14/2009
Last updated
05/14/2009
Update your record
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