| Lake Dental Of Saratoga, Pc | |
|
176 Lake Ave Saratoga Springs NY 12866-2529 | |
| (518) 935-0068 | |
| (518) 581-1145 |
| Full Name | Lake Dental Of Saratoga, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 176 Lake Ave, Saratoga Springs, New York |
| Authorized Official Name and Position | Tracie Lynn Dennis (BOOK KEEPER) |
| Authorized Official Contact | 5188172490 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Dental Of Saratoga, Pc 176 Lake Ave Saratoga Springs NY 12866-2529 Ph: (518) 935-0068 | Lake Dental Of Saratoga, Pc 176 Lake Ave Saratoga Springs NY 12866-2529 Ph: (518) 935-0068 |
| NPI Number | 1801196134 |
|---|---|
| Provider Enumeration Date | 11/03/2010 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801196134 | NPI | - | NPPES |
| 1710943774 | Medicaid | NY | |
| 1467654178 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 052845 (New York) | Primary |
| 1223G0001X | Dentist - General Practice | 022051-1 (New York) | Secondary |
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