| Albany Upstate Dental Pc | |
|
540 Broadway 100 Albany NY 12207-2708 | |
| (518) 465-0808 | |
| (518) 465-1450 |
| Full Name | Albany Upstate Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 540 Broadway, Albany, New York |
| Authorized Official Name and Position | Tariq Pasha Malik (OWNER / DENTIST) |
| Authorized Official Contact | 5184650808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Albany Upstate Dental Pc 540 Broadway 100 Albany NY 12207-2708 Ph: (518) 465-0808 | Albany Upstate Dental Pc 540 Broadway 100 Albany NY 12207-2708 Ph: (518) 465-0808 |
| NPI Number | 1457772931 |
|---|---|
| Provider Enumeration Date | 12/30/2013 |
| Last Update Date | 12/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457772931 | NPI | - | NPPES |
| 1811906563 | Other | NY | SOLE PROPERITER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 050817 (New York) | Primary |
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