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Organization

BURNSIDE DENTAL AND ORTHODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JUAN JIMENEZ (BUSINESS OWNER)
(718) 299-2972
Entity
Organization

Contact information

Practice address
1942 HARRISON AVE, BRONX, NY 10453-4502
(718) 299-2972
(718) 731-0565
Mailing address
1942 HARRISON AVE, BRONX, NY 10453-4502
(718) 299-2972
(718) 731-0565

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
033591-1
NY
1223G0001X
General Practice Dentistry
Primary
046812-1
NY
1223G0001X
General Practice Dentistry
053179-1
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
054040-1
NY

Other

Enumeration date
11/15/2008
Last updated
11/15/2008
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