Gross, Theodore C

Gross, Theodore C is an sole proprietor health care provider with primary practice located at 12 Davis Ave , Poughkeepsie NY 12603. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Suppliers / Durable Medical Equipment & Medical Supplies. Dental Providers / Dentist is his primary health care specialty. Gross, Theodore C can be contacted via phone (845) 473-4565.

Contact Information

Primary practice address
12 Davis Ave Poughkeepsie NY 12603
Phone: (845) 473-4565
Fax: (845) 484-1721
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 036441 New York
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 036441 New York

Profile Details

NPI number 1770639213
LBN Legal business name Gross, Theodore C
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2007
Last updated May 16th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770639213 NPPES
New York MEDICAID 00722376

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