| Robert Dictrow Dds, Bruce S. Logue Dds, Pc | |
|
652 Suffolk Avenue Brentwood NY 11717 | |
| (631) 273-0988 | |
| (631) 273-0949 |
| Full Name | Robert Dictrow Dds, Bruce S. Logue Dds, Pc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 652 Suffolk Avenue, Brentwood, New York |
| Authorized Official Name and Position | Bruce S. Logue (VP) |
| Authorized Official Contact | 6312730988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Dictrow Dds, Bruce S. Logue Dds, Pc 652 Suffolk Avenue Brentwood NY 11717 Ph: (631) 273-0988 | Robert Dictrow Dds, Bruce S. Logue Dds, Pc 652 Suffolk Avenue Brentwood NY 11717 Ph: (631) 273-0988 |
| NPI Number | 1225240385 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225240385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 029219 (New York) | Primary |
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