Healthcare Provider Details

I. General information

NPI: 1952824799
Provider Name (Legal Business Name): DAVID DAHAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 07/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1092 MADISON AVE
ALBANY NY
12208-2248
US

IV. Provider business mailing address

20 PARK ST
ALBANY NY
12207-1604
US

V. Phone/Fax

Practice location:
  • Phone: 518-525-1757
  • Fax:
Mailing address:
  • Phone: 514-594-3755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: