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Organization
NORTHEAST FAMILY DENTAL PLLC
Active
Organization
NORTHEAST FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARINA R MANUNTS DDS (OWNER)
(607) 257-0060
Entity
Organization
Contact information
Practice address
2329 N TRIPHAMMER RD, ITHACA, NY 14850-1011
(607) 257-0060
(607) 257-0042
Mailing address
2329 N TRIPHAMMER RD, ITHACA, NY 14850-1011
(607) 257-0060
(607) 257-0042
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050046-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02299296
—
NY
Enumeration date
02/12/2007
Last updated
05/12/2008
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