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General NPI Number Information
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NPI Number | 1346603636
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Entity Type | Organization
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Legal Business Name | CHESTER HILL DENTAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 04/04/2016
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Last Update Date | 04/04/2016
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Provider Practice Location Address
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Address Line | 395 WESTCHESTER AVE
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City | PORT CHESTER
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State | NY
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Zip | 10573-3651
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Country | US
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Telephone | 914-937-2810
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Fax |
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Provider Business Mailing Address
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Address Line | 395 WESTCHESTER AVE
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City | PORT CHESTER
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State | NY
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Zip | 10573-3651
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Country | US
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Telephone | 914-937-2810
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Fax | 914-937-0570
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. CHI D FU
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Credential | DDS
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Telephone | 914-937-2810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 028973
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License Number State | NY
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