| Renaissance Dental Pc | |
|
4 Normanskill Blvd Delmar NY 12054-1335 | |
| (518) 261-4800 | |
| Not Available |
| Full Name | Renaissance Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 4 Normanskill Blvd, Delmar, New York |
| Authorized Official Name and Position | Marina Shraga (PRESIDENT) |
| Authorized Official Contact | 5182614800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Dental Pc 4 Normanskill Blvd Delmar NY 12054-1335 Ph: (518) 261-4800 | Renaissance Dental Pc 4 Normanskill Blvd Delmar NY 12054-1335 Ph: (518) 261-4800 |
| NPI Number | 1457729337 |
|---|---|
| Provider Enumeration Date | 09/09/2015 |
| Last Update Date | 09/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457729337 | NPI | - | NPPES |
| 02721117 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 052174 (New York) | Secondary |
| 122300000X | Dentist | 052174 (New York) | Primary |
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