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General NPI Number Information
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NPI Number | 1639391428
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Entity Type | Individual
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Provider Name | CYNTHIA ANN GILBERT-PATTISON DMD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 195 S MAPLE AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-5142
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Country | US
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Telephone | 201-652-7020
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Fax |
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Provider Business Mailing Address
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Address Line | 11 COUNTRY CLUB RD
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City | TENAFLY
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State | NJ
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Zip | 07670-2621
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Country | US
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Telephone | 201-567-6355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DI018921
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License Number State | NJ
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