| Endicott Dental Surgery, Pllc | |
|
609 E Main St Ste 9 Endicott NY 13760-5036 | |
| (607) 239-6400 | |
| (607) 239-6422 |
| Full Name | Endicott Dental Surgery, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 609 E Main St Ste 9, Endicott, New York |
| Authorized Official Name and Position | Michael P Wilson (OWNER) |
| Authorized Official Contact | 6072396400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Endicott Dental Surgery, Pllc 609 E Main St Ste 9 Endicott NY 13760-5036 Ph: (607) 239-6400 | Endicott Dental Surgery, Pllc 609 E Main St Ste 9 Endicott NY 13760-5036 Ph: (607) 239-6400 |
| NPI Number | 1588973713 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 10/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588973713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 50-052924 (New York) | Primary |
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