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General NPI Number Information
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NPI Number | 1629484399
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Entity Type | Organization
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Legal Business Name | DUNNING FAMILY DENTAL
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 191 GUY PARK AVE
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City | AMSTERDAM
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State | NY
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Zip | 12010-3254
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Country | US
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Telephone | 518-842-3220
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Fax | 518-843-0830
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Provider Business Mailing Address
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Address Line | 191 GUY PARK AVE
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City | AMSTERDAM
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State | NY
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Zip | 12010-3254
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Country | US
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Telephone | 518-842-3220
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Fax | 518-843-0830
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY J D'ADDIO
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Credential | DMD
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Telephone | 518-842-3220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 040098
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License Number State | NY
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