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General NPI Number Information
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NPI Number | 1649646308
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Entity Type | Organization
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Legal Business Name | DANIELLO & EIGO ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 191 LAKE AVE
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-2530
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Country | US
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Telephone | 518-587-8777
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Fax | 518-587-1138
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Provider Business Mailing Address
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Address Line | 191 LAKE AVE
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-2530
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Country | US
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Telephone | 518-587-8777
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Fax | 518-587-1138
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. THOMAS EIGO
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Credential | DDS
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Telephone | 518-222-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 046051
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 044228
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License Number State | NY
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