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General NPI Number Information
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NPI Number | 1346954732
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Entity Type | Organization
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Legal Business Name | MOTIVATIONAL DENTISTRY P C
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 97 1/2 GEORGE ST
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City | TROY
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State | NY
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Zip | 12183-1115
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Country | US
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Telephone | 518-308-4200
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Fax | 518-308-4300
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Provider Business Mailing Address
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Address Line | 97 1/2 GEORGE ST
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City | TROY
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State | NY
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Zip | 12183-1115
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Country | US
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Telephone | 518-308-4200
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Fax | 518-308-4300
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. SHONTERAL LAKAY REDMOND
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Credential | DDS
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Telephone | 607-591-2305
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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 |
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License Number State |
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