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Organization

DELANCEY DENTAL, P.C.

Active
Other names
.All Access Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICK MASCARENHAS DDS (PRESIDENT, CHIEF CLINICAL OFFICER)
(212) 695-5057
Entity
Organization

Contact information

Practice address
288 MAIN ST, BEACON, NY 12508-3015
(845) 838-0086
Mailing address
1350 BROADWAY, SUITE 2104, NEW YORK, NY 10018-7702
(212) 695-5057
(212) 242-3241

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0489681
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0016750
DORAL USA PROVIDER NUMBER
NY
05
02099310
NY
05
02634917
NY
05
02691725
NY
05
02713422
NY
01
A1807
HEALTHPLEXINC. PROVIDER #
NY
Enumeration date
10/12/2006
Last updated
05/16/2012
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