Stephen Arthur Ahlgrim – General Practice Dentistry

Key facts

NPI: 1376662239
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 039123-1 (NY)
Practice address: 125 Mullin St
Watertown, NY 13601-3615
Phone: (315) 782-2241
Fax: (315) 785-5521
NPI assigned: Mar 29, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Ahlgrim and Ward Dental Associates Dental Clinic/Center · Watertown, NY · NPI 1811160567

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
039123-1	NY	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Ahlgrim and Ward Dental Associates		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	039123-1	NY	Yes

Addresses

Primary practice location

125 Mullin St
Watertown, NY 13601-3615

Mailing address

125 Mullin St
Watertown, NY 13601-3615
Phone (315) 782-2241

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All providers in Watertown, NY · General Practice Dentistry in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.