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General NPI Number Information
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NPI Number | 1427222652
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Entity Type | Organization
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Legal Business Name | AMERICAN DENTAL PRACTICE PC
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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 | 2258 WESTERN AVE
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City | GUILDERLAND
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State | NY
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Zip | 12084-9701
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Country | US
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Telephone | 518-218-2292
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Fax | 518-218-2293
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Provider Business Mailing Address
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Address Line | 2258 WESTERN AVE
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City | GUILDERLAND
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State | NY
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Zip | 12084-9701
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Country | US
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Telephone | 518-218-2292
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Fax | 518-218-2293
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Authorized Official
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Title or Position | DENTIST
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Name | DR. INDERPAL SINGH GARCHA
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Credential | D.D.S
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Telephone | 518-218-2292
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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 | 050067
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License Number State | NY
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