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General NPI Number Information
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NPI Number | 1295953248
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Entity Type | Organization
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Legal Business Name | COLUMBIA DENTAL ASSOC.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18 WILDERNESS LN
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City | VALATIE
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State | NY
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Zip | 12184
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Country | US
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Telephone | 518-758-6359
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Fax | 518-758-9359
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Provider Business Mailing Address
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Address Line | PO BOX 806
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City | VALATIE
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State | NY
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Zip | 12184-0806
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Country | US
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Telephone | 518-758-6359
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Fax | 518-758-9359
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MIRIAM D SCHNEIDER
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Credential | DMD
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Telephone | 518-758-6359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 045388
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License Number State | NY
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