Provider Demographics
NPI:1992893796
Name:TRAMONTANA, CHARLES M (DDS)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:TRAMONTANA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 SAND CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-2434
Mailing Address - Country:US
Mailing Address - Phone:518-869-5348
Mailing Address - Fax:518-452-1744
Practice Address - Street 1:576 SAND CREEK RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-2434
Practice Address - Country:US
Practice Address - Phone:518-869-5348
Practice Address - Fax:518-452-1744
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0314991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice