Provider Demographics
NPI:1346753761
Name:NEW CITY FAMILY DENTAL GROUP P.C.
Entity Type:Organization
Organization Name:NEW CITY FAMILY DENTAL GROUP P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SEO
Authorized Official - Middle Name:YEON
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-634-6006
Mailing Address - Street 1:555 NORTH AVE APT 10P
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2412
Mailing Address - Country:US
Mailing Address - Phone:646-271-0453
Mailing Address - Fax:
Practice Address - Street 1:100 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4134
Practice Address - Country:US
Practice Address - Phone:845-634-6006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0532401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty