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General NPI Number Information
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NPI Number | 1649687591
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Entity Type | Organization
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Legal Business Name | SCHOHARIE DENTAL, PLLC
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 107 PROSPECT ST
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City | SCHOHARIE
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State | NY
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Zip | 12157
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Country | US
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Telephone | 518-459-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 165 MANNING BLVD
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City | ALBANY
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State | NY
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Zip | 12203-1756
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Country | US
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Telephone | 518-459-2444
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. MUSTAFA SABAI
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Credential | DDS
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Telephone | 518-459-2444
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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 | 056403
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 049893
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License Number State | NY
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