Organization
PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARZAD SANI DDS (PARTNER)
(518) 798-9966
Entity
Organization
Contact information
Practice address
88 BROAD STREET, GLENS FALLS, NY 12801
(518) 798-9966
(518) 798-0616
Mailing address
88 BROAD STREET, GLENS FALLS, NY 12801
(518) 798-9966
(518) 798-0616
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105880
DORAL DENTAL
NY
01
—
816446
UNITED CONCORDIA
NY
01
—
Q428
CDPHP
NY
01
—
X00129970
EXCELLUS
NY
Enumeration date
01/30/2007
Last updated
08/22/2020
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