Provider Demographics
NPI:1114028560
Name:COTUGNO DENTAL ASSOCIATES PC
Entity Type:Organization
Organization Name:COTUGNO DENTAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:COTUGNO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:518-725-0420
Mailing Address - Street 1:212 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078
Mailing Address - Country:US
Mailing Address - Phone:518-725-0420
Mailing Address - Fax:518-773-0665
Practice Address - Street 1:212 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078
Practice Address - Country:US
Practice Address - Phone:518-725-0420
Practice Address - Fax:518-773-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty