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General NPI Number Information
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NPI Number | 1821267121
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Entity Type | Organization
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Legal Business Name | PHYLLIS A NORTON DDS & NATALIA M. BAUSBACK DMD P.C.
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 324 N GREENBUSH ROAD
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City | TROY
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State | NY
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Zip | 12180-8518
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Country | US
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Telephone | 518-286-5354
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Fax |
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Provider Business Mailing Address
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Address Line | 324 N GREENBUSH RD
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City | TROY
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State | NY
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Zip | 12180-8518
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Country | US
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Telephone | 518-286-5354
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHYLLIS A NORTON
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Credential |
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Telephone | 518-286-5354
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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 | 0400515
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License Number State | NY
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