Provider Demographics
NPI:1750096640
Name:GARRITY, MADISON LEE (DDS)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:LEE
Last Name:GARRITY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148B ROCKLAND HALL DIVISION OF DENTAL ANESTHESIOLOGY
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8711
Mailing Address - Country:US
Mailing Address - Phone:631-632-6364
Mailing Address - Fax:
Practice Address - Street 1:148B ROCKLAND HALL DIVISION OF DENTAL ANESTHESIOLOGY
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8711
Practice Address - Country:US
Practice Address - Phone:631-632-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program