| NPI | 1760214530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE SHAKYA Dentist/Owner 518-466-4294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology | |
| 1223P0300X Dentist, Periodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |