Family Dentistry Pc | |
89 North St Granville NY 12832-1138 | |
(518) 642-2111 | |
(518) 642-2891 |
Full Name | Family Dentistry Pc |
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Speciality | Dentist |
Location | 89 North St, Granville, New York |
Authorized Official Name and Position | Jennifer R Kelley (DENTIST) |
Authorized Official Contact | 5186422111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Family Dentistry Pc 89 North St Granville NY 12832-1138 Ph: (518) 642-2111 | Family Dentistry Pc 89 North St Granville NY 12832-1138 Ph: (518) 642-2111 |
NPI Number | 1215920632 |
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Provider Enumeration Date | 08/31/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215920632 | NPI | - | NPPES |
1010081 | Medicaid | VT | |
02375744 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |