Provider Demographics
NPI:1144570839
Name:ALBANY FAMILY DENTISTRY P.C.
Entity Type:Organization
Organization Name:ALBANY FAMILY DENTISTRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BHUPINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BHATTAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:518-491-4553
Mailing Address - Street 1:552 ACLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-3079
Mailing Address - Country:US
Mailing Address - Phone:518-783-2233
Mailing Address - Fax:518-783-2244
Practice Address - Street 1:592 NEW LOUDON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-4035
Practice Address - Country:US
Practice Address - Phone:518-783-2233
Practice Address - Fax:518-783-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049797-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty