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1225448855
MICHAEL JOHN DESIVO
EAST ISLIP, NY
NPI
1225448855
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NY 057983-1)
Enumeration Date
2014-05-05
Last Update Date
2017-04-11
Business Address
Dr. MICHAEL JOHN DESIVO D.D.S.
228 EAST MAIN ST
EAST ISLIP, NY 11730
Phone number: 631-983-6281
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Mailing Address
Dr. MICHAEL JOHN DESIVO D.D.S.
228 EAST MAIN ST
EAST ISLIP, NY 11730
Phone number: 631-983-6281
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