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Organization
WILLSBORO DENTAL, PC
Active
Organization
WILLSBORO DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BONFANTE DDS (PRESIDENT)
(518) 963-7307
Entity
Organization
Contact information
Practice address
3673 ESSEX ROAD, WILLSBORO, NY 12996
(518) 963-7307
Mailing address
PO BOX 310, 3673 ESSEX ROAD, WILLSBORO, NY 12996
(518) 963-7307
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
030808
NY
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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