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General NPI Number Information
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NPI Number | 1245404318
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Entity Type | Organization
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Legal Business Name | HIGHLAND MILLS DENTAL CARE
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 583 ROUTE 32 SUITE 1
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City | HIGHLAND MILLS
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State | NY
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Zip | 10930-5200
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Country | US
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Telephone | 845-928-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 583 ROUTE 32 P.O. BOX 464
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City | HIGHLAND MILLS
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State | NY
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Zip | 10930-5200
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Country | US
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Telephone | 845-928-3348
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. KATHY BERHANES
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Credential |
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Telephone | 845-928-3348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0527341
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License Number State | NY
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