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General NPI Number Information
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NPI Number | 1174651210
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Entity Type | Individual
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Provider Name | RENEE FAIRMONT DDS
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 5114 LAZY K TRL
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City | BALLSTON SPA
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State | NY
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Zip | 12020-2586
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Country | US
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Telephone | 917-399-3559
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Fax |
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Provider Business Mailing Address
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Address Line | 172 KAYDEROSS PARK RD
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-8704
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Country | US
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Telephone | 917-399-5474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN17802
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License Number State | FL
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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 | 052839-1
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License Number State | NY
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