MEDICARE: PATIENT 1ST DENTAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	048645-1	NY

General Provider Information

NPI Number	:	1245445717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENT 1ST DENTAL CARE

Provider Business Mailing Address
First Line	:	2293 ST. GEORGES AVE.
Second Line	:
City	:	RAHWAY
State	:	NJ
Zip	:	07065
Country	:	US
Telephone Number	:	917-609-8555
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 5TH AVE.
Second Line	:	SUITE 2618
City	:	NEW YORK
State	:	NY
Zip	:	10118
Country	:	US
Telephone Number	:	917-609-8555
Fax Number	:	732-381-2997

Authorized Official
Title or Position	:	OWNER
Name	:	RAMONCITO C BENITO
Credential	:	DDS
Telephone Number	:	917-609-8555

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	08/22/2020

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