Provider Demographics
NPI:1558865766
Name:GRUFFI, CONOR ELIZABETH (DDS)
Entity Type:Individual
Prefix:
First Name:CONOR
Middle Name:ELIZABETH
Last Name:GRUFFI
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 1:2 PERLMAN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5230
Mailing Address - Country:US
Mailing Address - Phone:845-573-9860
Mailing Address - Fax:
Practice Address - Street 1:2 PERLMAN DR STE 101
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5230
Practice Address - Country:US
Practice Address - Phone:518-641-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0609391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice