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General NPI Number Information
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NPI Number | 1508885898
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Entity Type | Organization
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Legal Business Name | ESOPUS DENTAL, PC
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 105 WOODCREST DRIVE
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City | RIFTON
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State | NY
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Zip | 12471
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Country | US
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Telephone | 845-658-8131
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Fax |
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Provider Business Mailing Address
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Address Line | 10 HELLBROOK LANE
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City | ULSTER PARK
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State | NY
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Zip | 12487
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Country | US
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Telephone | 845-481-7014
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JOSEF LOEWENTHAL
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Credential | DDS
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Telephone | 845-481-7014
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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 | 52863
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License Number State | NY
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