Provider Demographics
NPI:1184006306
Name:POLASKI DENTAL GROUP PLLC
Entity Type:Organization
Organization Name:POLASKI DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:POLASKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:845-246-3070
Mailing Address - Street 1:8 ULSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-1211
Mailing Address - Country:US
Mailing Address - Phone:845-246-3070
Mailing Address - Fax:845-246-6014
Practice Address - Street 1:8 ULSTER AVE
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-1211
Practice Address - Country:US
Practice Address - Phone:845-246-3070
Practice Address - Fax:845-246-6014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty