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Organization
UNION STREET DENTISTRY
Active
Organization
UNION STREET DENTISTRY
Active
Other names
Union Street Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELINA M SANTA MARIA (PRACTICE ADMINISTRATOR)
(518) 346-6429
Entity
Organization
Contact information
Practice address
1740 UNION ST, SCHENECTADY, NY 12309-6233
(518) 346-6429
(518) 346-8495
Mailing address
1740 UNION ST, SCHENECTADY, NY 12309-6233
(518) 346-6429
(518) 346-8495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051914-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046910-1
NEW YORK LICENSE
NY
01
—
051914-1
NY LICENSE NUMBER
NY
01
—
051925-1
NEW YORK LICENSE
NY
Enumeration date
10/21/2008
Last updated
10/21/2008
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