Organization · NPI-2

Advanced Dental Technologies Cor

Dentist, General Practice · Oceanside, NY

NPI number1679968408
StatusActive
Last updated in NPPESJul 20, 2015

Details

NPI
1679968408
Entity type
Organization (NPI-2)
Legal business name
Advanced Dental Technologies Cor
Organization subpart
No
Enumeration date
Mar 30, 2015
Last updated
Jul 20, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice029836-1NYYes

Practice location

2983 Long Beach Rd
Oceanside, NY 11572-3204

Phone 516-536-5777

Mailing address

2983 Long Beach Rd
Oceanside, NY 11572-3204

Phone 516-536-5777

Authorized official

John C Peterson
President
5165365777

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