| Ident Dental At Suffern | |
|
156 Route 59 Suite A1 Suffern NY 10901-5005 | |
| (845) 356-8844 | |
| Not Available |
| Full Name | Ident Dental At Suffern |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 156 Route 59, Suffern, New York |
| Authorized Official Name and Position | Joseph Fertucci (PRESIDENT) |
| Authorized Official Contact | 9142457977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ident Dental At Suffern 200 Westage Business Ctr Dr Suite 233 Fishkill NY 12524-2264 Ph: (845) 897-2097 | Ident Dental At Suffern 156 Route 59 Suite A1 Suffern NY 10901-5005 Ph: (845) 356-8844 |
| NPI Number | 1033541552 |
|---|---|
| Provider Enumeration Date | 08/07/2013 |
| Last Update Date | 08/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033541552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 047222 (New York) | Primary |
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