Healthcare Provider Details

I. General information

NPI: 1902814064
Provider Name (Legal Business Name): CONGERS DENTAL CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LAKE RD SUITE 4
CONGERS NY
10920-2251
US

IV. Provider business mailing address

1 LAKE RD SUITE 4
CONGERS NY
10920-2251
US

V. Phone/Fax

Practice location:
  • Phone: 845-268-3304
  • Fax: 845-268-3349
Mailing address:
  • Phone: 845-268-3304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number042456
License Number StateNY

VIII. Authorized Official

Name: DR. ALKA PATEL
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 845-268-3304