Organization · Type 2 NPI

North Country Pediatric Dentistry PLLC

Pediatric Dentistry · Malone, NY

NPI number 1821723362 Active

Practice location

447 E Main St
Malone, NY 12953-2126

Call (518) 483-0100 Map

Fax (518) 483-0101

Mailing address

29 N Airmont Rd Ste 22
Suffern, NY 10901-4242

Specialties and licenses

Taxonomy	Code	License
Dental Anesthesiology	1223D0004X	None listed
General Practice Dentistry	1223G0001X	None listed
Pediatric Dentistry Primary	1223P0221X	None listed
Oral and Maxillofacial Surgery (Dentist)	1223S0112X	None listed
Orthodontics and Dentofacial Orthopedics Dentistry	1223X0400X	None listed

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

NPI record

NPI: 1821723362
Entity type: Organization (Type 2)
Issued: Jul 19, 2022
Last updated: Jul 12, 2023
Status: Active

Other names

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Pediatric Dentistry of Malone · doing business as
Pediatric Dentistry of Malone · doing business as

Authorized official

Barry L Jacobson, DMD
Owner
(845) 369-3703

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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 1821723362

North Country Pediatric Dentistry PLLC's National Provider Identifier is 1821723362, issued on Jul 19, 2022. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Malone, NY. The record was last updated on Jul 12, 2023.