Provider Demographics
NPI:1134797665
Name:TOURO COLLEGE OF DENTAL MEDICINE FACULTY PRACTICE CORPORATION
Entity type:Organization
Organization Name:TOURO COLLEGE OF DENTAL MEDICINE FACULTY PRACTICE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT TO VICE DEAN
Authorized Official - Prefix:
Authorized Official - First Name:DANICA
Authorized Official - Middle Name:O
Authorized Official - Last Name:CURRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-594-2647
Mailing Address - Street 1:19 SKYLINE DRIVE
Mailing Address - Street 2:COMPLEX CLINIC
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1524
Mailing Address - Country:US
Mailing Address - Phone:914-594-2706
Mailing Address - Fax:914-594-2681
Practice Address - Street 1:19 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2134
Practice Address - Country:US
Practice Address - Phone:914-594-2700
Practice Address - Fax:914-594-2681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty