Provider Demographics
NPI:1245394857
Name:DR GARY H FINNERTY DDS PC
Entity Type:Organization
Organization Name:DR GARY H FINNERTY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:H
Authorized Official - Last Name:FINNERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:315-633-2462
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:7820 KNEESKERN RD
Mailing Address - City:BRIDGEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:13030
Mailing Address - Country:US
Mailing Address - Phone:315-633-2462
Mailing Address - Fax:315-633-0734
Practice Address - Street 1:7820 KNEESKERN RD
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:NY
Practice Address - Zip Code:13030
Practice Address - Country:US
Practice Address - Phone:315-633-2462
Practice Address - Fax:315-633-0734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
045816122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty