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Organization
IDENT DENTAL AT MIDDLETOWN
Active
Organization
IDENT DENTAL AT MIDDLETOWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM SPOSATO (ADMINISTRATOR)
(914) 245-4332
Entity
Organization
Contact information
Practice address
453 ROUTE 211 E, SUITE 103, MIDDLETOWN, NY 10940-2206
(888) 433-6820
Mailing address
453 ROUTE 211 E, SUITE 103, MIDDLETOWN, NY 10940-2206
(888) 433-6820
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
048328
NY
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
049967
NY
1223P0300X
Periodontics
051732
NY
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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