| Clinton High School | |
|
100 W Mosholu Pkwy S Bronx NY 10468-1001 | |
| (718) 696-4071 | |
| Not Available |
| Full Name | Clinton High School |
|---|---|
| Speciality | Dentist |
| Location | 100 W Mosholu Pkwy S, Bronx, New York |
| Authorized Official Name and Position | Charles Brocket (ADMINISTRATOR) |
| Authorized Official Contact | 7189204167 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinton High School Po Box 4156 Church Street Station New York NY 10261-4156 Ph: (718) 920-4649 | Clinton High School 100 W Mosholu Pkwy S Bronx NY 10468-1001 Ph: (718) 696-4071 |
| NPI Number | 1710161161 |
|---|---|
| Provider Enumeration Date | 12/20/2007 |
| Last Update Date | 12/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710161161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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