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General NPI Number Information
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NPI Number | 1093688657
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Entity Type | Organization
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Legal Business Name | SCHENECTADY PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 1019 KEYES AVE
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City | SCHENECTADY
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State | NY
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Zip | 12309-5749
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Country | US
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Telephone | 518-545-4040
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Fax | 518-203-1548
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Provider Business Mailing Address
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Address Line | 1019 KEYES AVE
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City | SCHENECTADY
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State | NY
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Zip | 12309-5749
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Country | US
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Telephone | 518-545-4040
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Fax | 518-203-1548
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | BETH WEISBECK
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Credential |
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Telephone | 720-469-3909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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