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NPI Code Detail

MEDICARE: DR. JOHN DENNIS DYER DDS

MEDICARE: DR. JOHN DENNIS DYER DDS
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
11223G0001XGeneral Practice Dentistry051657NY

General Provider Information

NPI Number : 1710066691
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN DENNIS DYER DDS
Provider Business Mailing Address
First Line : 55 W END AVE
Second Line : APT. #S2J
City : NEW YORK
State : NY
Zip : 10023-7842
Country : US
Telephone Number : 718-866-7452
Fax Number :
Provider Business Practice Location Address
First Line : 111 E 210TH ST
Second Line : DENTAL DEPARTMENT
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number : 718-920-4984
Fax Number : 718-515-5419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 07/08/2007

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