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General NPI Number Information
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NPI Number | 1487741831
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Entity Type | Organization
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Legal Business Name | GEORGE MENKEN DDS PC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 180 PHILLIPS HILL ROAD
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City | NEW CITY
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State | NY
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Zip | 10956
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Country | US
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Telephone | 845-634-2929
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Fax | 845-634-2934
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Provider Business Mailing Address
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Address Line | 180 PHILLIPS HILL ROAD
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City | NEW CITY
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State | NY
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Zip | 10956
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Country | US
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Telephone | 845-634-2929
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Fax | 845-634-2934
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE MENKEN
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Credential | DDS PC
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Telephone | 845-634-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 18934
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License Number State | NY
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