Organization Name: | CHESTER HILL DENTAL ASSOCIATES, PLLC |
NPI Number: | 1346603636 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHI D FU (ADMINISTRATOR) |
Mailing Address: | 395 Westchester Ave Port Chester |
State: | NY US |
Postal Code: | 105733651 |
Phone Number: | 9149372810 |
Fax Number: | |
NPI Enumeration Date: | 04/04/2016 |
NPI Last Update Date: | 04/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 028973 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |