Provider Demographics
NPI:1013308766
Name:HUDSON HIGHLANDS DENTISTRY, LLC
Entity Type:Organization
Organization Name:HUDSON HIGHLANDS DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:845-343-6908
Mailing Address - Street 1:22 MULBERRY ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-5741
Mailing Address - Country:US
Mailing Address - Phone:845-343-6908
Mailing Address - Fax:845-343-5850
Practice Address - Street 1:22 MULBERRY ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5741
Practice Address - Country:US
Practice Address - Phone:845-343-6908
Practice Address - Fax:845-343-5850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty