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General NPI Number Information
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NPI Number | 1295042836
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Entity Type | Organization
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Legal Business Name | LANIER DENTAL LLC
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 110 WASHINGTON AVE
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City | PLEASANTVILLE
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State | NY
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Zip | 10570-2838
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Country | US
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Telephone | 914-747-4700
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Fax | 914-747-0437
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Provider Business Mailing Address
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Address Line | 110 WASHINGTON AVE
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City | PLEASANTVILLE
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State | NY
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Zip | 10570-2838
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Country | US
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Telephone | 914-747-4700
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Fax | 914-747-0437
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MARIANGELA VALERIO
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Credential |
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Telephone | 914-747-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0291491
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License Number State | NY
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