MEDICARE: A BETTER SMILE FAMILY DENTISTRY PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	040776	NY

General Provider Information

NPI Number	:	1952371635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A BETTER SMILE FAMILY DENTISTRY PC

Provider Business Mailing Address
First Line	:	681 SARATOGA RD RT 9
Second Line	:	PO BOX 2360
City	:	WILTON
State	:	NY
Zip	:	12831
Country	:	US
Telephone Number	:	518-584-2128
Fax Number	:	518-584-0045

Provider Business Practice Location Address
First Line	:	681 SARATOGA RD RT 9
Second Line	:
City	:	WILTON
State	:	NY
Zip	:	12831
Country	:	US
Telephone Number	:	518-584-2128
Fax Number	:	518-584-0045

Authorized Official
Title or Position	:	DOCTOR OWNER PRESIDENT
Name	:	DR. RICHARD LEE DUNHAM
Credential	:	DMD
Telephone Number	:	518-584-2128

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	08/22/2020

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