Provider Demographics
NPI:1174651210
Name:FAIRMONT, RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:
Last Name:FAIRMONT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 KAYDEROSS PARK RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-8704
Mailing Address - Country:US
Mailing Address - Phone:917-399-5474
Mailing Address - Fax:
Practice Address - Street 1:5114 LAZY K TRL
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-2586
Practice Address - Country:US
Practice Address - Phone:917-399-3559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17802122300000X
NY052839-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist