VICTORIA ELENA SHACK

PORT JEFFERSON, NY
NPI1538427802
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: NY  056759-1)
Enumeration Date2012-04-24
Last Update Date2013-09-06
Business Address
-- VICTORIA ELENA SHACK DDS
150 N COUNTRY RD APT A10
PORT JEFFERSON, NY 11777-2154
Phone number: 917-324-7927
Mailing Address
-- VICTORIA ELENA SHACK DDS
150 N COUNTRY RD APT A10
PORT JEFFERSON, NY 11777-2154
Phone number: 917-324-7927