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17 Quaker Path Stony Brook NY 11790-1307 | |
| (631) 751-0065 | |
| (631) 751-0103 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17 Quaker Path, Stony Brook, New York |
| Authorized Official Name and Position | Thomas William Riutta (OWNER) |
| Authorized Official Contact | 6317510065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
17 Quaker Path Stony Brook NY 11790-1307 Ph: (631) 751-0065 | 17 Quaker Path Stony Brook NY 11790-1307 Ph: (631) 751-0065 |
| NPI Number | 1851592042 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851592042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 046699 (New York) | Primary |
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