| NPI | 1114936929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN R HOERTDOERFER Owner/Dentist 516-679-7978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NY 022088) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 044865) |
| 122300000X Dentist (Licence: NY 051494) | |
| 1223P0300X Dentist, Periodontics (Licence: NY 049186) | |
| 124Q00000X Dental Hygienist (Licence: NY 016591) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-09-11 |