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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

NPI Number 1215200779
LBN Legal business name COLLEGETOWN FAMILY DENTAL
Authorized official KRISTNA KAPUR - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/14/2012
Last updated 02/14/2012 - About 14 years ago
Identifiers
NY License # 044135
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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