Healthcare Provider Details

I. General information

NPI: 1083086383
Provider Name (Legal Business Name): TENDER DENTAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 10/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 CROTON AVE
OSSINING NY
10562-4216
US

IV. Provider business mailing address

95 CROTON AVE
OSSINING NY
10562-4216
US

V. Phone/Fax

Practice location:
  • Phone: 914-941-3209
  • Fax:
Mailing address:
  • Phone: 914-941-3209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number055353
License Number StateNY

VIII. Authorized Official

Name: DR. KAMILIA SAID
Title or Position: MEMBER
Credential: DMD
Phone: 860-205-3390