Provider Demographics
NPI:1497900344
Name:SOMERS PEDIATRIC DENTISTRY PC
Entity Type:Organization
Organization Name:SOMERS PEDIATRIC DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-358-1225
Mailing Address - Street 1:374 ROUTE 116
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-2628
Mailing Address - Country:US
Mailing Address - Phone:914-358-1225
Mailing Address - Fax:914-358-1227
Practice Address - Street 1:374 ROUTE 116
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-2628
Practice Address - Country:US
Practice Address - Phone:914-358-1225
Practice Address - Fax:914-358-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY500514561223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty