# IDENT DENTAL AT FISHKILL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033343413
- **Authorized official:** ADAN SPOSATO (ADMINISTRATOR)
- **Authorized official phone:** (888) 433-6820

## Contact information

- **Practice address:** 200 WESTAGE BUSINESS CTR DR, SUITE 233, FISHKILL, NY 12524-2264
- **Practice address phone:** (914) 245-4332
- **Mailing address:** 200 WESTAGE BUSINESS CTR DR, SUITE 233, FISHKILL, NY 12524-2264
- **Mailing address phone:** (888) 433-6820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 048328 | NY | — |
| 1223P0300X | Periodontics | 051732 | NY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 049967 | NY | Yes |

## Other

- **Enumeration date:** 05/13/2009
- **Last updated:** 05/13/2009