Organization
PEDIATRIC DENTISTRY OF ALBANY, PLLC
Active
Parent organization
PEDIATRIC DENTISTRY OF ALBANY, PLLC
Other names
Dental Surgery Suite of Schenectady
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC DENTISTRY OF ALBANY, PLLC
Authorized official
DR. BARRY L JACOBSON DMD (CEO)
(845) 369-3703
Entity
Organization
Contact information
Practice address
624 MCCLELLAN ST STE G01, SCHENECTADY, NY 12304-1024
(518) 512-3072
(518) 621-7286
Mailing address
29 N AIRMONT RD STE 22, SUFFERN, NY 10901-4242
(845) 369-3703
(845) 369-3183
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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