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General NPI Number Information
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NPI Number | 1699229062
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Entity Type | Organization
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Legal Business Name | DENTAL DEVICES, PC
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 1340 WASHINGTON ST
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City | WATERTOWN
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State | NY
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Zip | 13601-4541
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Country | US
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Telephone | 315-681-6050
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Fax | 315-221-4338
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Provider Business Mailing Address
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Address Line | PO BOX 91
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City | WATERTOWN
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State | NY
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Zip | 13601-0091
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Country | US
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Telephone | 315-681-6050
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Fax | 315-221-4338
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Authorized Official
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Title or Position | OWNER
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Name | DR. SARAH LATIF
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Credential | DDS
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Telephone | 315-681-6050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 052833
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 055118
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License Number State | NY
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