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General NPI Number Information
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NPI Number | 1710091871
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Entity Type | Organization
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Legal Business Name | DELMAR DENTAL PC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 344 DELAWARE AVE
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City | DELMAR
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State | NY
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Zip | 12054
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Country | US
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Telephone | 518-439-4228
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Fax | 518-439-4598
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Provider Business Mailing Address
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Address Line | DELMAR DENTAL PC 344 DELAWARE AVE
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City | DELMAR
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State | NY
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Zip | 12054
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Country | US
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Telephone | 518-439-4228
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Fax | 518-439-4598
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS H ABELE
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Credential | DMD
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Telephone | 518-439-4228
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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 | 028248-1
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License Number State | NY
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