Paul Dana Harbottle, D.D.S.
Individual provider Active NPI Dentist · Somers, NY
NPI 1295871317 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295871317
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 045872 (NY)
- Practice address
- 380 Route 202
Somers Professional Commons
Somers, NY 10589-3222 - Phone
- (914) 277-3518
- Fax
- (914) 277-1020
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009121 | CT | MD | Dentist |
| 045872 | NY | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 045872 | NY | Yes |
| Dentist | 122300000X | 009121 | CT |
Addresses
Primary practice location
380 Route 202
Somers Professional Commons
Somers, NY 10589-3222
Mailing address
681 Titicus Rd
North Salem, NY 10560-1801
Phone (914) 669-9626
Other providers in Somers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.