Brewerton Family Dentistry

LBN: Brewerton Family Dentistry
Brewerton Family Dentistry is an health care organization with primary practice located at 5501 Bartel Rd , Brewerton NY 13029-8701. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Brewerton Family Dentistry can be contacted via phone (315) 676-2209, or through Nosegbe, Imadeh R via phone (315) 676-2209.

Contact Information

Primary practice address
5501 Bartel Rd Brewerton NY 13029-8701
Phone: (315) 676-2209
Fax: (315) 676-2247
Website:
Map and Directions
Authorized official contact:
Name: Nosegbe, Imadeh R Doctor of Dental Medicine (DMD)
Phone: (315) 676-2209

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 051614 New York

Profile Details

NPI number 1164553079
LBN Legal business name Brewerton Family Dentistry
DBA Doing business as
Authorized official Nosegbe, Imadeh R Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 9th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164553079 NPPES
New York MEDICAID 02570547

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