Organization
IDENT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM SPOSATO (OPERATIONS DIRECTOR)
(646) 208-1456
Entity
Organization
Contact information
Practice address
711 CANAL ST # 250, STAMFORD, CT 06902-6094
(203) 548-0826
Mailing address
200 WESTAGE BUSINESS CTR DR STE 233, FISHKILL, NY 12524-2262
(845) 897-2097
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/22/2021
Last updated
03/22/2021
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