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General NPI Number Information
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NPI Number | 1508081985
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Entity Type | Organization
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Legal Business Name | HIGH PEAKS DENTAL PROFESSIONAL PARTNERSHIP
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 55 BARN RD SUITE 201
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City | LAKE PLACID
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State | NY
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Zip | 12946-1050
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Country | US
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Telephone | 518-523-8288
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Fax | 518-523-5986
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Provider Business Mailing Address
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Address Line | 55 BARN RD SUITE 201
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City | LAKE PLACID
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State | NY
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Zip | 12946-1051
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Country | US
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Telephone | 518-523-8288
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Fax | 518-523-5986
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Authorized Official
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Title or Position | PARTNER
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Name | MR. WILLIAM P CALDON
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Credential | D.M.D.
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Telephone | 518-523-8288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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