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Contact Information

COLLEGETOWN FAMILY DENTAL
324 DRYDEN RD.
ITHACA, NY14850
 Phone: 607-272-2131
 Fax: 607-272-2132
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for COLLEGETOWN FAMILY DENTAL · (Female)

NPI Number 1215200779
Status Active
Credentials
Entity Individual
Enumeration date 02/14/2012
Last updated 02/14/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 044135
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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