Provider Demographics
NPI:1871123661
Name:DENTAL ARTS OF HASTINGS ON HUDSON
Entity type:Organization
Organization Name:DENTAL ARTS OF HASTINGS ON HUDSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBENEDICTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-737-6300
Mailing Address - Street 1:615 BROADWAY STE SW1
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-1039
Mailing Address - Country:US
Mailing Address - Phone:914-693-0199
Mailing Address - Fax:914-693-3569
Practice Address - Street 1:615 BROADWAY STE SW1
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-1039
Practice Address - Country:US
Practice Address - Phone:914-693-0199
Practice Address - Fax:914-693-3569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies