| Fall Creek Family Dentist | |
|
501 N Cayuga St Ithaca NY 14850-3670 | |
| (607) 272-8118 | |
| Not Available |
| Full Name | Fall Creek Family Dentist |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 501 N Cayuga St, Ithaca, New York |
| Authorized Official Name and Position | Kathy Kinney (OFFICE MANAGER) |
| Authorized Official Contact | 6072728118 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fall Creek Family Dentist 501 N Cayuga St Ithaca NY 14850-3670 Ph: (607) 272-8118 | Fall Creek Family Dentist 501 N Cayuga St Ithaca NY 14850-3670 Ph: (607) 272-8118 |
| NPI Number | 1356600233 |
|---|---|
| Provider Enumeration Date | 05/11/2012 |
| Last Update Date | 05/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356600233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 044135 (New York) | Primary |
| 261QD0000X | Clinic/center - Dental | 044297 (New York) | Secondary |
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