| Commack Pediatric Dental Assoc Llp | |
|
164 Commack Rd. Ste 4 Commack NY 11725 | |
| (631) 499-2112 | |
| (631) 858-0586 |
| Full Name | Commack Pediatric Dental Assoc Llp |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 164 Commack Rd., Commack, New York |
| Authorized Official Name and Position | Eric Gherman (DENTIST/PARTNER) |
| Authorized Official Contact | 6314992112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commack Pediatric Dental Assoc Llp 164 Commack Rd. Ste 4 Commack NY 11725 Ph: (631) 499-2112 | Commack Pediatric Dental Assoc Llp 164 Commack Rd. Ste 4 Commack NY 11725 Ph: (631) 499-2112 |
| NPI Number | 1598914236 |
|---|---|
| Provider Enumeration Date | 09/18/2008 |
| Last Update Date | 09/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598914236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 035281 (New York) | Primary |
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