Columbia Dental Group | |
515 Columbia Drive Johnson City NY 13790 | |
(607) 770-1122 | |
(607) 770-1176 |
Full Name | Columbia Dental Group |
---|---|
Speciality | Dentist - General Practice |
Location | 515 Columbia Drive, Johnson City, New York |
Authorized Official Name and Position | Roger Antonio Conti (PARTNER) |
Authorized Official Contact | 6077701122 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Columbia Dental Group 515 Columbia Drive Johnson City NY 13790 Ph: (607) 770-1122 | Columbia Dental Group 515 Columbia Drive Johnson City NY 13790 Ph: (607) 770-1122 |
NPI Number | 1891825600 |
---|---|
Provider Enumeration Date | 03/07/2007 |
Last Update Date | 04/30/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891825600 | NPI | - | NPPES |
104448556 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 041409 (New York) | Primary |
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