Healthcare Provider Details

I. General information

NPI: 1932012929
Provider Name (Legal Business Name): SMILEWORKS DENTAL OF THE HUDSON VALLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E FRONT ST
HANCOCK NY
13783-1242
US

IV. Provider business mailing address

275 NORTH ST
NEWBURGH NY
12550-3143
US

V. Phone/Fax

Practice location:
  • Phone: 607-298-2404
  • Fax: 607-298-2080
Mailing address:
  • Phone: 845-561-2494
  • Fax: 845-561-0681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CARY DANIEL WAGNER
Title or Position: PRESIDENT
Credential:
Phone: 845-561-2494