Individual
CALIXTO M BARRUECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D,D.S
Contact information
Practice address
173 E MAIN ST, AMSTERDAM, NY 12010-4818
(518) 843-6100
Mailing address
173 E MAIN ST, AMSTERDAM, NY 12010-4818
(518) 843-6100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046354-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01667463
—
NY
Enumeration date
10/23/2006
Last updated
07/08/2007
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