Provider Demographics
NPI:1588826739
Name:DUTCHESS COUNTY DENTAL SERVICES
Entity Type:Organization
Organization Name:DUTCHESS COUNTY DENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FERTUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-437-4380
Mailing Address - Street 1:2600 SOUTH RD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-7003
Mailing Address - Country:US
Mailing Address - Phone:845-437-4380
Mailing Address - Fax:845-214-0124
Practice Address - Street 1:2600 SOUTH RD
Practice Address - Street 2:SUITE 21
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-7003
Practice Address - Country:US
Practice Address - Phone:845-437-4380
Practice Address - Fax:845-214-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0472221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty