Provider Demographics
NPI:1093944688
Name:PATCH, CLAUDIA GUTMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:GUTMAN
Last Name:PATCH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BRUNEL DR
Mailing Address - Street 2:
Mailing Address - City:BOICEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12412-5116
Mailing Address - Country:US
Mailing Address - Phone:860-833-1219
Mailing Address - Fax:
Practice Address - Street 1:121 ROUTE 375
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1815
Practice Address - Country:US
Practice Address - Phone:845-679-3706
Practice Address - Fax:845-679-7594
Is Sole Proprietor?:No
Enumeration Date:2009-07-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055016-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist