Provider Demographics
NPI:1316577109
Name:WHITE PLAINS FAMILY DENISTRY PLLC
Entity Type:Organization
Organization Name:WHITE PLAINS FAMILY DENISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBENEDICTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-428-2052
Mailing Address - Street 1:16 MARTINE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1909
Mailing Address - Country:US
Mailing Address - Phone:914-428-2052
Mailing Address - Fax:914-428-0304
Practice Address - Street 1:16 MARTINE AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-1909
Practice Address - Country:US
Practice Address - Phone:914-428-2052
Practice Address - Fax:914-428-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies