Provider Demographics
NPI:1891024485
Name:EASTERN FAMILY DENTAL P.C
Entity Type:Organization
Organization Name:EASTERN FAMILY DENTAL P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VINEET
Authorized Official - Middle Name:
Authorized Official - Last Name:MORE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-882-9922
Mailing Address - Street 1:1140 EASTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4108
Mailing Address - Country:US
Mailing Address - Phone:917-882-9922
Mailing Address - Fax:718-221-2014
Practice Address - Street 1:1140 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4108
Practice Address - Country:US
Practice Address - Phone:917-882-9922
Practice Address - Fax:718-221-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty