Organization
GOLD COAST DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE SEYENA-SUSU DDS (DENTIST)
(845) 471-8855
Entity
Organization
Contact information
Practice address
695 DUTCHESS TPKE, SUITE 104, POUGHKEEPSIE, NY 12603-6442
(845) 471-8855
Mailing address
695 DUTCHESS TPKE, SUITE 104, POUGHKEEPSIE, NY 12603-6442
(845) 471-8855
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
050398
NY
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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