| North Shore Periodontics, Pc | |
|
2001 Marcus Ave Ste E244 Suite E244 New Hyde Park NY 11042-1011 | |
| (516) 706-2912 | |
| Not Available |
| Full Name | North Shore Periodontics, Pc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2001 Marcus Ave Ste E244, New Hyde Park, New York |
| Authorized Official Name and Position | Gregory Davis (PRESIDENT) |
| Authorized Official Contact | 5167750018 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Periodontics, Pc 2001 Marcus Ave Ste E244 Suite E244 New Hyde Park NY 11042-1011 Ph: (516) 706-2912 | North Shore Periodontics, Pc 2001 Marcus Ave Ste E244 Suite E244 New Hyde Park NY 11042-1011 Ph: (516) 706-2912 |
| NPI Number | 1679753669 |
|---|---|
| Provider Enumeration Date | 11/07/2007 |
| Last Update Date | 11/07/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679753669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 043137 (New York) | Primary |
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