Provider Demographics
NPI:1821118647
Name:RICHARD DRUCE, D.D.S., P.A.
Entity Type:Organization
Organization Name:RICHARD DRUCE, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-342-4334
Mailing Address - Street 1:419 E MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2552
Mailing Address - Country:US
Mailing Address - Phone:845-342-4334
Mailing Address - Fax:845-342-6011
Practice Address - Street 1:419 E MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2552
Practice Address - Country:US
Practice Address - Phone:845-342-4334
Practice Address - Fax:845-342-6011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0410581223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD8F842Medicare PIN