Organization
FAMILY DENTAL ASSOCIATES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETRA VICTORIA ENZIEN DMD (DENTIST PARTNER)
(518) 664-0762
Entity
Organization
Contact information
Practice address
211 PARK AVE, MECHANICVILLE, NY 12118
(518) 664-0762
(518) 664-0765
Mailing address
211 PARK AVE, MECHANICVILLE, NY 12118
(518) 664-0762
(518) 664-0765
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0461981
NY
122300000X
Dentist
Primary
046460
NY
Other
Enumeration date
07/02/2006
Last updated
08/22/2020
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