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Contact Information

BROOKSIDE FAMILY DENTAL CORP
399 HOOVER AVE
SUITE 1
BLOOMFIELD, NJ07003
 Phone: 973-566-6161
 Fax: 973-566-0866
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for BROOKSIDE FAMILY DENTAL CORP

NPI Number 1053585612
LBN Legal business name BROOKSIDE FAMILY DENTAL CORP
Authorized official KINDA YACOUB - (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date 04/15/2008
Last updated 04/15/2008 - About 18 years ago
Identifiers
NJ License # D1020914
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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