Organization
DENTRUST DENTAL NEW YORK, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA CLARK (DIRECTOR OF CREDENTIALING)
(672) 362-5938
Entity
Organization
Contact information
Practice address
254 CAFFERTY RD, PIPERSVILLE, PA 18947-9337
(610) 294-7994
(610) 294-7995
Mailing address
254 CAFFERTY RD, PIPERSVILLE, PA 18947-9337
(610) 294-7994
(610) 294-7995
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046252-01
LC LIC NY
NY
Enumeration date
10/10/2006
Last updated
02/20/2023
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