Provider Demographics
NPI:1508087644
Name:STEVENS TRIMBOLI, DONNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:STEVENS TRIMBOLI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 IBM RD
Mailing Address - Street 2:SUITE 203B
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5455
Mailing Address - Country:US
Mailing Address - Phone:845-462-1542
Mailing Address - Fax:845-462-1602
Practice Address - Street 1:22 IBM RD
Practice Address - Street 2:SUITE 203B
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5455
Practice Address - Country:US
Practice Address - Phone:845-462-1542
Practice Address - Fax:845-462-1602
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037675-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice