| Creative Dental Arts,llc | |
|
1127 Dalewood St Kingston NY 12401-1011 | |
| (845) 336-5114 | |
| Not Available |
| Full Name | Creative Dental Arts,llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1127 Dalewood St, Kingston, New York |
| Authorized Official Name and Position | Stanley Weiss (MEMBER) |
| Authorized Official Contact | 8453365114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Dental Arts,llc 1127 Dalewood St Kingston NY 12401-1011 Ph: (845) 336-5114 | Creative Dental Arts,llc 1127 Dalewood St Kingston NY 12401-1011 Ph: (845) 336-5114 |
| NPI Number | 1912071358 |
|---|---|
| Provider Enumeration Date | 11/18/2006 |
| Last Update Date | 07/31/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912071358 | NPI | - | NPPES |
| 00290611 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 026337 (New York) | Primary |
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