| NPI | 1750795530 |
|---|---|
| Doing Business As | DBA CLIFTON PARK PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | HEIDI MARIE HANNA Office Manager 518-630-5420 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2014-07-02 |