National Provider Identifier

David Douglas Gardner

David Douglas Gardner is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Andover, NY and a listed phone number of (607) 478-8426.

NPI 1770569535Andover, NYGeneral Practice Dentistry

Profile Overview

NPI
1770569535
Provider Type
Individual
Primary Specialty
General Practice Dentistry
Enumeration Date
December 22, 2005
Last Updated
July 08, 2007

Practice Location

  • 2 South Main St
  • Andover, NY 14806

Phone: (607) 478-8426

Mailing Address

  • 9 Malin Ln
  • Penfield, NY 14526-2232

Specialties

  • General Practice Dentistry (1223G0001X)
Full Record
NPI
1770569535
Entity Type
Individual
Last Name
Gardner
First Name
David
Middle Name
Douglas
Mailing Street Address
9 Malin Ln
Mailing City
Penfield
Mailing State
NY
Mailing ZIP Code
14526-2232
Mailing Country
US
Mailing Phone
(585) 864-9704
Practice Street Address
2 South Main St
Practice City
Andover
Practice State
NY
Practice ZIP Code
14806
Practice Country
US
Practice Phone
(607) 478-8426
Enumeration Date
December 22, 2005
Last Updated
July 08, 2007
Sex
Male
Sole Proprietor
X
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X)