Provider Demographics
NPI:1811029135
Name:DENT, MICHAEL (SW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:DENT
Suffix:
Gender:M
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4218
Mailing Address - Country:US
Mailing Address - Phone:845-338-4538
Mailing Address - Fax:
Practice Address - Street 1:70 OVEROCKER RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2035
Practice Address - Country:US
Practice Address - Phone:845-485-9803
Practice Address - Fax:845-485-5234
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054585104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker