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Organization
SMALL SMILES DENTISTRY OF ALBANY, LLC
Active
Organization
SMALL SMILES DENTISTRY OF ALBANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRUDY WILLIAMS (DIRECTOR, LICENSING & CREDENTIALING)
(615) 750-0342
Entity
Organization
Contact information
Practice address
1839 CENTRAL AVE, ALBANY, NY 12205-4748
(518) 464-0402
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02633892
—
NY
01
—
A2378
WELLCARE / HEALTHPLEX
NY
01
—
S694
CDPHP
NY
Enumeration date
05/05/2006
Last updated
05/17/2010
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