Provider Demographics
NPI:1710091871
Name:DELMAR DENTAL PC
Entity Type:Organization
Organization Name:DELMAR DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:ABELE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:518-439-4228
Mailing Address - Street 1:DELMAR DENTAL PC
Mailing Address - Street 2:344 DELAWARE AVE
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054
Mailing Address - Country:US
Mailing Address - Phone:518-439-4228
Mailing Address - Fax:518-439-4598
Practice Address - Street 1:344 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054
Practice Address - Country:US
Practice Address - Phone:518-439-4228
Practice Address - Fax:518-439-4598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028248-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty