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General NPI Number Information
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NPI Number | 1477898187
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Entity Type | Organization
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Legal Business Name | TROY DENTAL PC
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 5 BROADWAY SUITE# 201
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City | TROY
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State | NY
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Zip | 12180-3226
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Country | US
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Telephone | 518-533-4989
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Fax |
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Provider Business Mailing Address
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Address Line | 12 CHATSWORTH WAY
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City | CLIFTON PARK
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State | NY
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Zip | 12065-7238
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Country | US
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Telephone | 212-844-9071
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHALINI AHUJA
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Credential | DDS
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Telephone | 212-844-9071
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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 | 050626
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License Number State | NY
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