| St Lawrence Dental Studio Pllc | |
|
14 Miner St Canton NY 13617-1286 | |
| (315) 379-9195 | |
| Not Available |
| Full Name | St Lawrence Dental Studio Pllc |
|---|---|
| Speciality | Dentist |
| Location | 14 Miner St, Canton, New York |
| Authorized Official Name and Position | Aleksandr Medved (OPERATING MANAGER) |
| Authorized Official Contact | 3153799195 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Lawrence Dental Studio Pllc 119 Miner Rd Malone NY 12953-6103 Ph: (518) 483-8157 | St Lawrence Dental Studio Pllc 14 Miner St Canton NY 13617-1286 Ph: (315) 379-9195 |
| NPI Number | 1922336973 |
|---|---|
| Provider Enumeration Date | 12/03/2009 |
| Last Update Date | 12/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922336973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 052242 (New York) | Primary |
Grasse River Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1956 Old Dekalb Rd, Canton, NY 13617 Phone: 315-386-2960 Fax: 315-386-2960 |