Provider Demographics
NPI:1861827396
Name:WAPPINGERS DENTAL, PLLC
Entity Type:Organization
Organization Name:WAPPINGERS DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GEORGESCU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-297-3950
Mailing Address - Street 1:115 NEW HACKENSACK ROAD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590
Mailing Address - Country:US
Mailing Address - Phone:845-297-3950
Mailing Address - Fax:
Practice Address - Street 1:115 NEW HACKENSACK ROAD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590
Practice Address - Country:US
Practice Address - Phone:845-297-3950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty