Healthcare Provider Details

I. General information

NPI: 1083716419
Provider Name (Legal Business Name): OSCAR ALVAREZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 WHITEHALL RD ALVAREZ DENTAL PLLC
ALBANY NY
12209
US

IV. Provider business mailing address

123 WHITEHALL RD ALVAREZ DENTAL PLLC
ALBANY NY
12209
US

V. Phone/Fax

Practice location:
  • Phone: 518-436-9771
  • Fax: 518-436-9794
Mailing address:
  • Phone: 518-436-9771
  • Fax: 518-436-9794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0457711
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: