Individual provider · NPI-1

Dr. Morton Durst, DDS

Dentist · Woodmere, NY

NPI number1366551004
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1366551004
Entity type
Individual (NPI-1)
Name
Dr. Morton Durst
Credential
DDS
Sex
Male
Sole proprietor
No
Enumeration date
Aug 29, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist0285181NYYes

Practice location

767 Central Ave
Woodmere, NY 11598-2636

Phone 516-374-6787 · Fax 516-374-6792

Mailing address

451 Beach 141st St
Rockaway Park, NY 11694-1246

Phone 718-945-6978 · Fax 718-945-7134

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