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1245536382
SHADY SAMUEL
MINEOLA, NY
NPI
1245536382
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: NY 055773)
Enumeration Date
2011-02-08
Last Update Date
2017-08-15
Business Address
-- SHADY SAMUEL
18 JEROME AVE
MINEOLA, NY 11501-3302
Phone number: 718-268-0452
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Mailing Address
-- SHADY SAMUEL
18 JEROME AVE
MINEOLA, NY 11501-3302
Phone number:
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