| Allied Dental Care P.c. | |
|
375 W Route 59 Spring Valley NY 10977-5339 | |
| (845) 352-5410 | |
| (845) 352-5412 |
| Full Name | Allied Dental Care P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 375 W Route 59, Spring Valley, New York |
| Authorized Official Name and Position | Yelena Nutskovsky (PRESIDENT) |
| Authorized Official Contact | 8453525410 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Allied Dental Care P.c. 375 W Route 59 Spring Valley NY 10977-5339 Ph: (845) 352-5410 | Allied Dental Care P.c. 375 W Route 59 Spring Valley NY 10977-5339 Ph: (845) 352-5410 |
| NPI Number | 1790099844 |
|---|---|
| Provider Enumeration Date | 07/31/2010 |
| Last Update Date | 07/31/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790099844 | NPI | - | NPPES |
| 02512861 | Medicaid | NY | |
| 1932154382 | Other | NY | PERSONAL NPI |
| 9178018 | Other | NY | FIDELIS ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 049884 (New York) | Primary |
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