Provider Demographics
NPI:1457653487
Name:MARIA LUCY DUFF DDS, P.C.
Entity Type:Organization
Organization Name:MARIA LUCY DUFF DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LUCY
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-524-0380
Mailing Address - Street 1:1121 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2406
Mailing Address - Country:US
Mailing Address - Phone:718-524-0380
Mailing Address - Fax:718-448-0890
Practice Address - Street 1:1121 FOREST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2406
Practice Address - Country:US
Practice Address - Phone:718-524-0380
Practice Address - Fax:718-448-0890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047103-21223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty