Provider Demographics
NPI:1689076614
Name:DOLINKY AND WATRY INC
Entity Type:Organization
Organization Name:DOLINKY AND WATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:DOLINKY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:916-705-0994
Mailing Address - Street 1:45 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-6781
Mailing Address - Country:US
Mailing Address - Phone:916-705-0094
Mailing Address - Fax:
Practice Address - Street 1:45 PHEASANT DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-6781
Practice Address - Country:US
Practice Address - Phone:916-705-0094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9189535261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center