Provider Demographics
NPI:1447779632
Name:GENTLE DENTAL AT NEW CITY PLLC
Entity Type:Organization
Organization Name:GENTLE DENTAL AT NEW CITY PLLC
Other - Org Name:COUNTY DENTAL AT NEW CITY PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SPOSATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-634-4909
Mailing Address - Street 1:151 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3851
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:151 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3851
Practice Address - Country:US
Practice Address - Phone:845-634-4909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY DENTAL AT NEW CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049660261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental