| Organization Name: | VALLEY PEDIATRIC DENTISTRY, PC |
| NPI Number: | 1225121551 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BENJAMIN DANCYGIER (PRESIDENT) |
| Mailing Address: | 3630 Hill Blvd Suite 401 Jefferson Valley |
| State: | NY US |
| Postal Code: | 105351502 |
| Phone Number: | 9142457100 |
| Fax Number: | 9142454423 |
| NPI Enumeration Date: | 09/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 0468391 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |