Organization
BOYNTON DENTAL,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMY FATOUH (PRESIDENT)
(718) 617-0624
Entity
Organization
Contact information
Practice address
1537 WESTCHESTER AVE, BRONX, NY 10472-2908
(718) 617-0624
(718) 328-3887
Mailing address
1537 WESTCHESTER AVE, BRONX, NY 10472-2908
(718) 617-0624
(718) 328-3887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
041973
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01087961
—
NY
05
—
01115177
—
NY
Enumeration date
03/24/2008
Last updated
03/24/2008
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