Provider Demographics
NPI:1740428168
Name:YORKTOWN DENTAL
Entity Type:Organization
Organization Name:YORKTOWN DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINCAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-898-6788
Mailing Address - Street 1:4326 GEORGE WASHINGTON MEM HWY
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2707
Mailing Address - Country:US
Mailing Address - Phone:757-898-6788
Mailing Address - Fax:757-898-1042
Practice Address - Street 1:4326 GEORGE WASHINGTON MEM HWY
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-2707
Practice Address - Country:US
Practice Address - Phone:757-898-6788
Practice Address - Fax:757-898-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty