Healthcare Provider Details

I. General information

NPI: 1386727683
Provider Name (Legal Business Name): KLETTER & LEVINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 HUDSON ST
SOUTH GLENS FALLS NY
12803-4945
US

IV. Provider business mailing address

63 HUDSON ST
SOUTH GLENS FALLS NY
12803-4945
US

V. Phone/Fax

Practice location:
  • Phone: 518-792-2187
  • Fax: 518-792-2188
Mailing address:
  • Phone: 518-792-2187
  • Fax: 518-792-2188

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: DR. ANDREW LEVINE
Title or Position: OWNER
Credential: DDS
Phone: 518-792-2187