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General NPI Number Information
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NPI Number | 1679123913
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Entity Type | Organization
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Legal Business Name | GOLDENS BRIDGE FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 190 GOLDENS BRIDGE RD STE 8
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City | KATONAH
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State | NY
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Zip | 10536-2804
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Country | US
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Telephone | 914-232-1070
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Fax | 914-232-1080
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Provider Business Mailing Address
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Address Line | 190 GOLDENS BRIDGE RD STE 8
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City | KATONAH
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State | NY
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Zip | 10536-2804
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Country | US
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Telephone | 914-232-1070
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Fax | 914-232-1080
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Authorized Official
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Title or Position | MEMBER
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Name | WEIYEE WONG
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Credential | DDS
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Telephone | 203-704-7890
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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 |
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License Number State |
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