Organization
ALLIED DENTAL CARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YELENA NUTSKOVSKY DMD (PRESIDENT)
(845) 352-5410
Entity
Organization
Contact information
Practice address
375 W ROUTE 59, SPRING VALLEY, NY 10977-5339
(845) 352-5410
(845) 352-5412
Mailing address
375 W ROUTE 59, SPRING VALLEY, NY 10977-5339
(845) 352-5410
(845) 352-5412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049884
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02512861
—
NY
01
—
1932154382
PERSONAL NPI
NY
01
—
9178018
FIDELIS ID
NY
Enumeration date
07/31/2010
Last updated
07/31/2010
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