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NPI Code Detail

MEDICARE: DR. PAUL DANA HARBOTTLE D.D.S.

MEDICARE: DR. PAUL DANA HARBOTTLE D.D.S.
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
1122300000XDentist045872NY
2122300000XDentist009121CT

General Provider Information

NPI Number : 1295871317
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL DANA HARBOTTLE D.D.S.
Provider Business Mailing Address
First Line : 681 TITICUS RD
Second Line :
City : NORTH SALEM
State : NY
Zip : 10560-1801
Country : US
Telephone Number : 914-669-9626
Fax Number :
Provider Business Practice Location Address
First Line : 380 ROUTE 202
Second Line : SOMERS PROFESSIONAL COMMONS
City : SOMERS
State : NY
Zip : 10589-3222
Country : US
Telephone Number : 914-277-3518
Fax Number : 914-277-1020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 07/08/2007

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