| University Dental Associates, Llp | |
|
90 Presidential Plz Ste 4130 Syracuse NY 13202-2240 | |
| (315) 464-2778 | |
| (315) 464-6524 |
| Full Name | University Dental Associates, Llp |
|---|---|
| Speciality | Dentist |
| Location | 90 Presidential Plz, Syracuse, New York |
| Authorized Official Name and Position | Robert N. Cooney (MD/CHAIRMAN) |
| Authorized Official Contact | 3154645549 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University Dental Associates, Llp 750 E Adams St Ste. 8141 Syracuse NY 13210-2306 Ph: (315) 464-5549 | University Dental Associates, Llp 90 Presidential Plz Ste 4130 Syracuse NY 13202-2240 Ph: (315) 464-2778 |
| NPI Number | 1235549569 |
|---|---|
| Provider Enumeration Date | 05/08/2014 |
| Last Update Date | 05/08/2014 |
| Medicare PECOS PAC ID | 0749667079 |
|---|---|
| Medicare Enrollment ID | O20220506000748 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235549569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 048166 (New York) | Primary |
| 1223G0001X | Dentist - General Practice | 048833 (New York) | Secondary |
| Provider Name | Jennifer Lonnen |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1013394220 PECOS PAC ID: 2961889290 Enrollment ID: I20220506001035 |
| Provider Name | Patrick B Smith |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1114955747 PECOS PAC ID: 1850778804 Enrollment ID: I20220513001306 |
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