Provider Demographics
NPI:1730149428
Name:FRANCIS, ERIC HENRY (DDS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:HENRY
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6237
Mailing Address - Country:US
Mailing Address - Phone:845-226-7548
Mailing Address - Fax:845-266-7052
Practice Address - Street 1:2 WILLOW DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6237
Practice Address - Country:US
Practice Address - Phone:845-226-7548
Practice Address - Fax:845-266-7052
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2012-12-01
Deactivation Date:2008-10-15
Deactivation Code:
Reactivation Date:2009-10-09
Provider Licenses
StateLicense IDTaxonomies
NY0496401223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0018099OtherDORAL
NY02199851Medicaid