Organization
DR. JEFFREY M. BACKER
Active
Other names
Scotia Glenville Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HELENE KOSSOFF (PRACTICE ADMINISTRATOR)
(518) 377-4431
Entity
Organization
Contact information
Practice address
214 MOHAWK AVE, SCOTIA, NY 12302-2129
(518) 377-4431
(518) 377-0415
Mailing address
214 MOHAWK AVE, SCOTIA, NY 12302-2129
(518) 377-4431
(518) 377-0415
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
053596-1
NY
1223G0001X
General Practice Dentistry
035839
NY
1223G0001X
General Practice Dentistry
Primary
036000
NY
1223G0001X
General Practice Dentistry
050472
NY
1223G0001X
General Practice Dentistry
050888
NY
1223G0001X
General Practice Dentistry
051703
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
023760
NY
Other
Enumeration date
10/23/2006
Last updated
09/19/2007
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