Provider Demographics
NPI:1932290210
Name:FULTON DENTAL HEALTH ASSOC
Entity Type:Organization
Organization Name:FULTON DENTAL HEALTH ASSOC
Other - Org Name:DENTAL HEALTH ASSOCIATES OSWERGO
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SACKS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:315-598-3700
Mailing Address - Street 1:205 ONEIDA STREET
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 ONEIDA STREET
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069
Practice Address - Country:US
Practice Address - Phone:315-598-3700
Practice Address - Fax:315-598-7269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty