Provider Demographics
NPI:1841595709
Name:DUKE FAMILY DENTISTRY PLLC
Entity Type:Organization
Organization Name:DUKE FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DUCREPIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEURINORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-504-3853
Mailing Address - Street 1:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-0007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 RIVER PLACE SUITE 1802
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10036
Practice Address - Country:US
Practice Address - Phone:646-504-3853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0544271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty