Provider Demographics
NPI:1639391428
Name:GILBERT-PATTISON, CYNTHIA ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANN
Last Name:GILBERT-PATTISON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:PATTISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:11 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2621
Mailing Address - Country:US
Mailing Address - Phone:201-567-6355
Mailing Address - Fax:
Practice Address - Street 1:195 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-5142
Practice Address - Country:US
Practice Address - Phone:201-652-7020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0189211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry