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Organization
SOUTH CENTRAL DENTAL IMPLANT PLLC
Active
Organization
SOUTH CENTRAL DENTAL IMPLANT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL YEHUDA IVRY DDS (OWNER)
(516) 561-7788
Entity
Organization
Contact information
Practice address
44 S CENTRAL AVE, SUITE #2, VALLEY STREAM, NY 11580-5432
(516) 561-7788
Mailing address
44 S CENTRAL AVE, SUITE #2, VALLEY STREAM, NY 11580-5432
(516) 561-7788
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
047962
NY
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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