Provider Demographics
NPI:1780758276
Name:RINTRONA, JOSEPH C (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:RINTRONA
Suffix:
Gender:M
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:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:NY
Mailing Address - Zip Code:13420-0099
Mailing Address - Country:US
Mailing Address - Phone:315-369-6634
Mailing Address - Fax:315-369-3198
Practice Address - Street 1:114 S SHORE ROAD
Practice Address - Street 2:TOW PROF BLDG
Practice Address - City:OLD FORGE
Practice Address - State:NY
Practice Address - Zip Code:13420
Practice Address - Country:US
Practice Address - Phone:315-369-6634
Practice Address - Fax:315-369-3198
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0295671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00587100Medicaid