Provider Demographics
NPI:1528383114
Name:VALHALLA DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:VALHALLA DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HILBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-949-1323
Mailing Address - Street 1:50 LEGION DR
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-2057
Mailing Address - Country:US
Mailing Address - Phone:914-949-1323
Mailing Address - Fax:914-421-0930
Practice Address - Street 1:50 LEGION DR
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-2057
Practice Address - Country:US
Practice Address - Phone:914-949-1323
Practice Address - Fax:914-421-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty