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NPI Code Detail

MEDICARE: ROTTERDAM DENTAL ASSOCIATES LLP

MEDICARE: ROTTERDAM DENTAL ASSOCIATES LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist046043NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689922171
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROTTERDAM DENTAL ASSOCIATES LLP
Provider Business Mailing Address
First Line : 1400 ALTAMONT AVE
Second Line :
City : SCHENECTADY
State : NY
Zip : 12303-2909
Country : US
Telephone Number : 518-355-2500
Fax Number :
Provider Business Practice Location Address
First Line : 1400 ALTAMONT AVE
Second Line :
City : SCHENECTADY
State : NY
Zip : 12303-2909
Country : US
Telephone Number : 518-355-2500
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ROSS KRASNOV
Credential : DDS
Telephone Number : 518-355-2500
Provider Enumeration Date : 08/15/2012
Last Update Date : 08/15/2012

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