Organization
CAPITAL AREA HUDSON VALLEY NEW YORK DENTAL PC
Active
Parent organization
CAPITAL AREA HUDSON VALLEY NEW YORK DENTAL PC
Other names
1st Advantage Dental Queensbury US 9, First Advantage Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAPITAL AREA HUDSON VALLEY NEW YORK DENTAL PC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
1092 STATE ROUTE 9, QUEENSBURY, NY 12804-1371
(518) 798-9561
Mailing address
1092 STATE ROUTE 9, QUEENSBURY, NY 12804-1371
(518) 798-9561
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01145404
—
NY
Enumeration date
07/25/2006
Last updated
05/31/2022
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