MEDICARE: NEW ROC DENTAL PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	048772	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639389851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW ROC DENTAL PC

Provider Business Mailing Address
First Line	:	271 NORTH AVE
Second Line	:	SUITE 212
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-5104
Country	:	US
Telephone Number	:	914-235-8065
Fax Number	:	914-235-8066

Provider Business Practice Location Address
First Line	:	271 NORTH AVE
Second Line	:	SUITE 212
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-5104
Country	:	US
Telephone Number	:	914-235-8065
Fax Number	:	914-235-8066

Authorized Official
Title or Position	:	OWNER
Name	:	DR. OVRAL JOY WYNTER
Credential	:	DDS
Telephone Number	:	914-235-8065

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	08/22/2020

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Directions to “NEW ROC DENTAL PC ” Practice Location

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