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Contact Information

THEODORE C GROSS, DDS
12 DAVIS AVE
POUGHKEEPSIE, NY12603
 Phone: 845-473-4565
 Fax: 845-484-1721
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for THEODORE C GROSS · (Male)

NPI # 1770639213
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 01/26/2007
Last updated 05/16/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 036441
  • NY Medicaid 00722376
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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