Organization
IDENT DENTAL AT FISHKILL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAN SPOSATO (ADMINISTRATOR)
(888) 433-6820
Entity
Organization
Contact information
Practice address
200 WESTAGE BUSINESS CTR DR, SUITE 233, FISHKILL, NY 12524-2264
(914) 245-4332
Mailing address
200 WESTAGE BUSINESS CTR DR, SUITE 233, FISHKILL, NY 12524-2264
(888) 433-6820
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
048328
NY
1223P0300X
Periodontics
051732
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
049967
NY
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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