| Lake Success Periodontics And Implants P.c. | |
|
1300 Union Tpke Suite 201 New Hyde Park NY 11040-1759 | |
| (516) 775-3737 | |
| (516) 775-3736 |
| Full Name | Lake Success Periodontics And Implants P.c. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1300 Union Tpke, New Hyde Park, New York |
| Authorized Official Name and Position | Michael Shreck (PRESIDENT) |
| Authorized Official Contact | 5167753737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Success Periodontics And Implants P.c. 1300 Union Tpke Suite 201 New Hyde Park NY 11040-1759 Ph: (516) 775-3737 | Lake Success Periodontics And Implants P.c. 1300 Union Tpke Suite 201 New Hyde Park NY 11040-1759 Ph: (516) 775-3737 |
| NPI Number | 1043417991 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 07/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043417991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 039925 (New York) | Primary |
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