OrganizationFamily Dental PcDentistDental ProvidersPractice Address645 W 207th St, New York, NY 10034-2654(212) 304-1666PECOS EnrollmentBased on the most recent information from CMS, provider Family Dental Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1770143364Provider TypeOrganizationFull NameFamily Dental PcSubpartNoEnumeration Date6/17/2019Last Updated6/17/2019Contact InformationPractice LocationPractice Address645 W 207th St, New York, NY 10034-2654Phone(212) 304-1666Fax(212) 304-1666Mailing LocationMailing Address645 W 207th St, New York, NY 10034-2654Phone(212) 304-1666Fax(212) 304-1666Authorized OfficialNameAkilov, Rudolf Dds (Dentist)Phone(212) 304-1666Provider TaxonomiesCodeDescriptionLicenseCode122300000XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer