MEDICARE: EASTERN FAMILY DENTAL P.C

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1891024485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTERN FAMILY DENTAL P.C

Provider Business Mailing Address
First Line	:	1140 EASTERN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-4108
Country	:	US
Telephone Number	:	917-882-9922
Fax Number	:	718-221-2014

Provider Business Practice Location Address
First Line	:	1140 EASTERN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-4108
Country	:	US
Telephone Number	:	917-882-9922
Fax Number	:	718-221-2014

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. VINEET MORE
Credential	:	DDS
Telephone Number	:	917-882-9922

Provider Enumeration Date	:	12/10/2009
Last Update Date	:	12/10/2009

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