| Tully Dental Office,llp | |
|
15 Warren St Tully NY 13159-2488 | |
| (315) 696-5792 | |
| (315) 696-5862 |
| Full Name | Tully Dental Office,llp |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 15 Warren St, Tully, New York |
| Authorized Official Name and Position | Anthony G Lombardo (PARTNER) |
| Authorized Official Contact | 3156965792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tully Dental Office,llp Po Box 585 Tully NY 13159-0585 Ph: (315) 696-5792 | Tully Dental Office,llp 15 Warren St Tully NY 13159-2488 Ph: (315) 696-5792 |
| NPI Number | 1780721696 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780721696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 036863 (New York) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 036927 (New York) | Primary |
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