Healthcare Provider Details

I. General information

NPI: 1053450593
Provider Name (Legal Business Name): ANTHONY J FURINO DDS MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARIS RD
NEW HARTFORD NY
13413-2350
US

IV. Provider business mailing address

1 PARIS RD
NEW HARTFORD NY
13413-2350
US

V. Phone/Fax

Practice location:
  • Phone: 315-724-5800
  • Fax: 315-724-0062
Mailing address:
  • Phone: 315-724-5800
  • Fax: 315-724-0062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number036500-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: