Provider Demographics
NPI:1629484399
Name:DUNNING FAMILY DENTAL
Entity Type:Organization
Organization Name:DUNNING FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:D'ADDIO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:518-842-3220
Mailing Address - Street 1:191 GUY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-3254
Mailing Address - Country:US
Mailing Address - Phone:518-842-3220
Mailing Address - Fax:518-843-0830
Practice Address - Street 1:191 GUY PARK AVE
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-3254
Practice Address - Country:US
Practice Address - Phone:518-842-3220
Practice Address - Fax:518-843-0830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty