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NPI Code Detail

MEDICARE: MIDDLETOWN DENTAL ASSOCIATES

MEDICARE: MIDDLETOWN DENTAL ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

General Provider Information

NPI Number : 1720606395
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDDLETOWN DENTAL ASSOCIATES
Provider Business Mailing Address
First Line : 225 DOLSON AVE STE 202
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-6570
Country : US
Telephone Number : 845-343-1486
Fax Number :
Provider Business Practice Location Address
First Line : 225 DOLSON AVE STE 202
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-6570
Country : US
Telephone Number : 845-343-1486
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : JOSEPH FABER
Credential :
Telephone Number : 845-343-1486
Provider Enumeration Date : 07/10/2020
Last Update Date : 07/10/2020

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Directions to “MIDDLETOWN DENTAL ASSOCIATES ” Practice Location

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