Organization · Type 2 NPI

Southwoods Boulevard Dental, P.c.

Oral and Maxillofacial Surgery (Dentist) · Albany, NY

NPI number 1730737545 Active

Practice location

7 Southwoods Blvd Ste 1
Albany, NY 12211-2526

Call (518) 445-2505 Map

Mailing address

330 Whitney Ave Ste 740
Holyoke, MA 01040-2789

Specialties and licenses

Taxonomy	Code	License
Oral and Maxillofacial Surgery (Dentist) Primary	1223S0112X	None listed

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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NPI record

NPI: 1730737545
Entity type: Organization (Type 2)
Issued: Aug 27, 2019
Last updated: Jan 10, 2022
Status: Active
Subpart: Yes of Southwoods Boulevard Dental, P.c.

Other names

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Capital District Oral & Maxillofacial Surgeons · doing business as
Capital District Oral & Maxillofacial Surgeons · doing business as

Authorized official

Leah Ann Maylott
Credentialing Administrator
(860) 874-8198

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1730737545

Southwoods Boulevard Dental, P.c.'s National Provider Identifier is 1730737545, issued on Aug 27, 2019. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Albany, NY. The record was last updated on Jan 10, 2022.