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Organization
PUTNAM DENTAL WELLNESS PLLC
Active
Organization
PUTNAM DENTAL WELLNESS PLLC
Active
Other names
Koala Dental Wellness NY-1
Organization subpart
No
Provider details
NPI number
Authorized official
CARL F ERN DDS (OWNER)
(845) 363-0400
Entity
Organization
Contact information
Practice address
2435 ROUTE 6 STE 5, BREWSTER, NY 10509-2538
(845) 363-0400
Mailing address
11825 STATE ROUTE 40, DUNLAP, IL 61525-8842
(309) 839-9941
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
07/23/2019
Last updated
04/07/2020
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