Osborne, Ty Dodson

Osborne, Ty Dodson is an sole proprietor health care provider with primary practice located at 90 Main St , Kings Park NY 11754-2719. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Osborne, Ty Dodson can be contacted via phone (631) 269-6812.

Contact Information

Primary practice address
90 Main St Kings Park NY 11754-2719
Phone: (631) 269-6812
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 055622 New York

Profile Details

NPI number 1386964583
LBN Legal business name Osborne, Ty Dodson
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2010
Last updated Aug 1st, 2011 - about 15 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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