Organization
DECKER,SBUTTONI,BOGHOSIAN,DICERBO SPECIALISTS IN ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. A. THOMAS DECKER D.M.D. (PRESIDENT)
(518) 489-8377
Entity
Organization
Contact information
Practice address
1004 WESTERN AVE, ALBANY, NY 12203-2743
(518) 489-8377
(518) 489-8462
Mailing address
1004 WESTERN AVE, ALBANY, NY 12203-2743
(518) 489-8377
(518) 489-8462
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0299761
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00555151
—
NY
Enumeration date
03/06/2007
Last updated
08/22/2020
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