Provider Demographics
NPI:1992796981
Name:DULING, ELIZABETH ELLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ELLEN
Last Name:DULING
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:ELLEN
Other - Last Name:SCALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10205 N. RIVA RIDGE LOOP
Mailing Address - Street 2:U.S. ARMY DENTAL ACTIVITY ATTN: CREDENTIALS
Mailing Address - City:FT. DRUM
Mailing Address - State:NY
Mailing Address - Zip Code:13602-5005
Mailing Address - Country:US
Mailing Address - Phone:315-772-4342
Mailing Address - Fax:315-772-9692
Practice Address - Street 1:10205 N. RIVA RIDGE LOOP
Practice Address - Street 2:U.S. ARMY DENTAL ACTIVITY ATTN: CREDENTIALS
Practice Address - City:FT. DRUM
Practice Address - State:NY
Practice Address - Zip Code:13602-5005
Practice Address - Country:US
Practice Address - Phone:315-772-4342
Practice Address - Fax:315-772-9692
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052217-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist