| NPI | 1144453226 |
|---|---|
| Doing Business As | 1ST ADVANTAGE DENTAL - COLONIE |
| Entity Type | Organization |
| Authorized Contact | CELIA HAYES Credentialing Coordinator 217-540-2100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 42469) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2022-08-15 |