Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 048888 | NY |
NPI | 1073653911 |
---|---|
Provider Name | Dr. John D Duthie |
First Address | Ithaca, NY 14850 |
Second Address | Ithaca, NY 14850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 08/07/2007 |