Healthcare Provider Details

I. General information

NPI: 1497869846
Provider Name (Legal Business Name): MICHAEL V. CONTE DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 GLENMONT RD.
GLENMONT NY
12077
US

IV. Provider business mailing address

PO BOX 127
GLENMONT NY
12077-0127
US

V. Phone/Fax

Practice location:
  • Phone: 518-472-8064
  • Fax: 518-449-0762
Mailing address:
  • Phone: 518-472-8064
  • Fax: 518-449-0762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number038731-1
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL V. CONTE
Title or Position: PRESIDENT/DENTIST
Credential: D.D.S.
Phone: 518-472-8064