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General NPI Number Information
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NPI Number | 1063877595
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Entity Type | Organization
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Legal Business Name | J & R FAMILY DENTISTRY PC
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 280 N CENTRAL AVE STE 482
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City | HARTSDALE
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State | NY
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Zip | 10530-1832
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Country | US
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Telephone | 914-682-0338
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Fax | 914-206-4149
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Provider Business Mailing Address
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Address Line | 280 N CENTRAL AVE STE 482
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City | HARTSDALE
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State | NY
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Zip | 10530-1832
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Country | US
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Telephone | 914-682-0338
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Fax | 914-206-4149
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT MYUNG-CHONG HWANG
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Credential |
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Telephone | 914-682-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 044559-1
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License Number State | NY
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