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207 Mohawk Ave # 1a Scotia NY 12302-2150 | |
(518) 535-3294 | |
Not Available |
Full Name | |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 207 Mohawk Ave # 1a, Scotia, New York |
Authorized Official Name and Position | Casey Lonabocker (VP STRATEGY AND OPERATIONS) |
Authorized Official Contact | 6175353364 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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131 Dartmouth St Fl 3 Boston MA 02116-5297 Ph: () - | 207 Mohawk Ave # 1a Scotia NY 12302-2150 Ph: (518) 535-3294 |
NPI Number | 1003571365 |
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Provider Enumeration Date | 11/02/2021 |
Last Update Date | 11/20/2024 |
Identifier | Type | State | Issuer |
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1003571365 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |