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Individual provider · Prosthodontics · Manhasset, NY

NPI
1326254418
Type
Individual (Type 1)
Primary specialty
Prosthodontics (Dentist)
Specialty group
Dental Providers
Taxonomy code
1223P0700X
License number
41230 (NY)
Sex
Male
Sole proprietor
No
Enumerated
2007-05-15
Last updated
2019-05-16
Practice location
2110 Northern Blvd, Suite 207
Manhasset, NY 11030-3502
(516) 482-5416

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