Palisades Mall Dental Llp | |
3645 Palisades Center Dr West Nyack NY 10994-6612 | |
(845) 353-3350 | |
Not Available |
Full Name | Palisades Mall Dental Llp |
---|---|
Speciality | Dentist |
Location | 3645 Palisades Center Dr, West Nyack, New York |
Authorized Official Name and Position | Ross Krasnov (OWNER) |
Authorized Official Contact | 8453533350 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Palisades Mall Dental Llp 3645 Palisades Center Dr West Nyack NY 10994-6612 Ph: (845) 353-3350 | Palisades Mall Dental Llp 3645 Palisades Center Dr West Nyack NY 10994-6612 Ph: (845) 353-3350 |
NPI Number | 1952601197 |
---|---|
Provider Enumeration Date | 10/21/2010 |
Last Update Date | 10/21/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952601197 | NPI | - | NPPES |
05180001 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 046043 (New York) | Primary |
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› Verified 9 days ago
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