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General NPI Number Information
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NPI Number | 1578058202
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Entity Type | Organization
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Legal Business Name | CHAPPAQUA DENTISTRY, P.C.
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 30 N GREELEY AVE
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City | CHAPPAQUA
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State | NY
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Zip | 10514-3410
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Country | US
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Telephone | 914-238-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 30 N GREELEY AVE
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City | CHAPPAQUA
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State | NY
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Zip | 10514-3410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN A. BRISMAN
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Credential | DMD
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Telephone | 914-238-8200
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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 | 039826
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License Number State | NY
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