| Brookside Family Dental Corp | |
|
399 Hoover Ave Suite 1 Bloomfield NJ 07003 | |
| (973) 566-6161 | |
| (973) 566-0866 |
| Full Name | Brookside Family Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 399 Hoover Ave, Bloomfield, New Jersey |
| Authorized Official Name and Position | Kinda Hanna Yacoub (DDS) |
| Authorized Official Contact | 9735666161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Family Dental Corp 399 Hoover Ave Suite 1 Bloomfield NJ 07003 Ph: (973) 566-6161 | Brookside Family Dental Corp 399 Hoover Ave Suite 1 Bloomfield NJ 07003 Ph: (973) 566-6161 |
| NPI Number | 1053585612 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 04/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053585612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D1020914 (New Jersey) | Primary |
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