| Delancey Dental, P.c. | |
|
288 Main St Beacon NY 12508-3015 | |
| (845) 838-0086 | |
| Not Available |
| Full Name | Delancey Dental, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 288 Main St, Beacon, New York |
| Authorized Official Name and Position | Patrick Mascarenhas (PRESIDENT, CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 2126955057 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delancey Dental, P.c. 1350 Broadway Suite 2104 New York NY 10018-7702 Ph: (212) 695-5057 | Delancey Dental, P.c. 288 Main St Beacon NY 12508-3015 Ph: (845) 838-0086 |
| NPI Number | 1134218498 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 05/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134218498 | NPI | - | NPPES |
| 02713422 | Medicaid | NY | |
| 02634917 | Medicaid | NY | |
| 02099310 | Medicaid | NY | |
| A1807 | Other | NY | HEALTHPLEXINC. PROVIDER # |
| 0016750 | Other | NY | DORAL USA PROVIDER NUMBER |
| 02691725 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0489681 (New York) | Primary |
Beacon Dental Pc Dental Clinic Medicare: Medicare Enrolled Practice Location: 1020 Wolcott Ave, Beacon, NY 12508 Phone: 845-838-3666 | |
Prospect Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 288th Main Street, Beacon, NY 12508 Phone: 845-838-0086 Fax: 845-765-2929 |