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Dr. Mitchell Douglas Duckworth, DDS
Student in an Organized Health Care Education/Training Program in Stony Brook, New York
NPI 1649530601

Mitchell Douglas Duckworth is a Student in an Organized Health Care Education/Training Program based in Stony Brook, NY. Mitchell Douglas Duckworth practices in Stony Brook, NY and has the professional credentials of DDS. The NPI Number for Mitchell Douglas Duckworth is 1649530601 and holds a License No. (New York).

The current practice location address for Mitchell Douglas Duckworth is Stony Brook University Hospital Dept Of, Stony Brook, NY and can be reached out via phone at 631-444-2557 and via fax at 631-444-6013.

Location: Stony Brook University Hospital Dept Of, Stony Brook, NY, 11794-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649530601
Provider Name
Mitchell Douglas Duckworth
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
Stony Brook University Hospital Dept Of, Stony Brook, NY, 11794-0001
Phone Number
631-444-2557
Fax Number
631-444-6013
Provider Enumeration Date
05/24/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
Stony Brook University Hospital Dept Of
City
Stony Brook
State
New York
Zip
11794-8711
Phone Number
631-444-2557
Fax Number
631-444-6013
person
Provider Business Mailing Address Details
Address
Stony Brook University Hospital Dept Of
City
Stony Brook
State
New York
Zip
11794-8711
Phone Number
631-444-2557
Fax Number
631-444-6013
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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