Provider Demographics
NPI:1649387564
Name:CORNING DENTAL ASSOCIATES RLLP
Entity Type:Organization
Organization Name:CORNING DENTAL ASSOCIATES RLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:607-937-5341
Mailing Address - Street 1:218 DENISON PARKWAY EAST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2889
Mailing Address - Country:US
Mailing Address - Phone:607-937-5341
Mailing Address - Fax:607-937-5344
Practice Address - Street 1:218 DENISON PARKWAY EAST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2889
Practice Address - Country:US
Practice Address - Phone:607-937-5341
Practice Address - Fax:607-937-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50029610122300000X
NY50031315122300000X
NY50029482122300000X
NY50049603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty