Provider Demographics
NPI:1225121551
Name:VALLEY PEDIATRIC DENTISTRY, PC
Entity Type:Organization
Organization Name:VALLEY PEDIATRIC DENTISTRY, PC
Other - Org Name:BENJAMIN DANCYGIER, DDS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANCYGIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-245-7100
Mailing Address - Street 1:3630 HILL BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:JEFFERSON VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10535-1502
Mailing Address - Country:US
Mailing Address - Phone:914-245-7100
Mailing Address - Fax:914-245-4423
Practice Address - Street 1:3630 HILL BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:JEFFERSON VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10535-1502
Practice Address - Country:US
Practice Address - Phone:914-245-7100
Practice Address - Fax:914-245-4423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0468391261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental