Provider Demographics
NPI:1346710241
Name:BEDFORD HILLS DENTAL P.C.
Entity Type:Organization
Organization Name:BEDFORD HILLS DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOVANOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-666-6845
Mailing Address - Street 1:3 DEPOT PLZ
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1807
Mailing Address - Country:US
Mailing Address - Phone:914-666-6845
Mailing Address - Fax:
Practice Address - Street 1:3 DEPOT PLZ
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-1807
Practice Address - Country:US
Practice Address - Phone:914-666-6845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty