Provider Demographics
NPI:1346954732
Name:MOTIVATIONAL DENTISTRY P C
Entity Type:Organization
Organization Name:MOTIVATIONAL DENTISTRY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHONTERAL
Authorized Official - Middle Name:LAKAY
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:607-591-2305
Mailing Address - Street 1:97 1/2 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12183-1115
Mailing Address - Country:US
Mailing Address - Phone:518-308-4200
Mailing Address - Fax:518-308-4300
Practice Address - Street 1:97 1/2 GEORGE ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12183-1115
Practice Address - Country:US
Practice Address - Phone:518-308-4200
Practice Address - Fax:518-308-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental