Provider Demographics
NPI:1437366499
Name:UTTERBACK, MADELINE NEUMAYER (DMD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:NEUMAYER
Last Name:UTTERBACK
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 1:1499 ROUTE 52 STE 25
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1625
Mailing Address - Country:US
Mailing Address - Phone:845-897-5140
Mailing Address - Fax:845-897-5141
Practice Address - Street 1:1499 ROUTE 52 STE 25
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1625
Practice Address - Country:US
Practice Address - Phone:845-897-5140
Practice Address - Fax:845-897-5141
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042806-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice