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General NPI Number Information
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NPI Number | 1952181976
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Entity Type | Organization
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Legal Business Name | CORNERSTONE PEDIATRIC DENTISTRY PC
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 1 PONDFIELD RD W STE 1R
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City | BRONXVILLE
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State | NY
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Zip | 10708-2648
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Country | US
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Telephone | 914-595-4190
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Fax | 914-595-4189
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Provider Business Mailing Address
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Address Line | 370 CENTRAL PARK W APT 501
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City | NEW YORK
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State | NY
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Zip | 10025-6521
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Country | US
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Telephone | 908-216-0400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA YOUNGERMAN
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Credential | DDS, MPH
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Telephone | 914-595-4190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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