Organization
IDENT DENTAL AT SUFFERN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH FERTUCCI (PRESIDENT)
(914) 245-7977
Entity
Organization
Contact information
Practice address
156 ROUTE 59, SUITE A1, SUFFERN, NY 10901-5005
(845) 356-8844
Mailing address
200 WESTAGE BUSINESS CTR DR, SUITE 233, FISHKILL, NY 12524-2264
(845) 897-2097
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
047222
NY
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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