| Rondout Valley Family Dentistry | |
|
10 Gagnon Drive Stone Ridge NY 12484 | |
| (845) 687-0600 | |
| (845) 687-7296 |
| Full Name | Rondout Valley Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10 Gagnon Drive, Stone Ridge, New York |
| Authorized Official Name and Position | Wayne William St. Hill (PRESIDENT) |
| Authorized Official Contact | 8456870600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rondout Valley Family Dentistry Po Box 235 Stone Ridge NY 12484-0235 Ph: (845) 687-0600 | Rondout Valley Family Dentistry 10 Gagnon Drive Stone Ridge NY 12484 Ph: (845) 687-0600 |
| NPI Number | 1548540800 |
|---|---|
| Provider Enumeration Date | 08/18/2011 |
| Last Update Date | 08/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548540800 | NPI | - | NPPES |
| 00465316 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 034680 (New York) | Primary |
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› Verified 3 days ago
Phillip E. Parker, D.d.s., Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3669 Main Street, Stone Ridge, NY 12484 Phone: 845-687-0066 |