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General NPI Number Information
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NPI Number | 1851594113
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Entity Type | Organization
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Legal Business Name | ST. CLARE'S HOSPITAL DENTAL HEALTH CLINIC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 600 MCCLELLAN ST
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City | SCHENECTADY
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State | NY
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Zip | 12304-1009
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Country | US
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Telephone | 518-347-5270
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Fax |
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Provider Business Mailing Address
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Address Line | 600 MCCLELLAN ST
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City | SCHENECTADY
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State | NY
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Zip | 12304-1009
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Country | US
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Telephone | 518-347-5270
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | AVIVA ANDREEN
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Credential | DDS
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Telephone | 518-347-5270
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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 |
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License Number State | NY
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