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General NPI Number Information
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NPI Number | 1134495203
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Entity Type | Organization
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Legal Business Name | NEW PALTZ DENTAL CARE PLLC
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Dates
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Enumeration Date | 03/22/2012
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Last Update Date | 03/22/2012
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Provider Practice Location Address
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Address Line | 3 PLATTEKILL AVE
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City | NEW PALTZ
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State | NY
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Zip | 12561-1918
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Country | US
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Telephone | 845-255-8350
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Fax | 845-255-2620
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Provider Business Mailing Address
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Address Line | 3 PLATTEKILL AVE
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City | NEW PALTZ
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State | NY
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Zip | 12561-1918
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Country | US
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Telephone | 845-255-8350
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Fax | 845-255-2620
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JOEL FISCHER
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Credential | DDS
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Telephone | 845-255-8350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 031553
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License Number State | NY
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