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Organization

PM DENTAL SERVICES P.C.

Active
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Organization

PM DENTAL SERVICES P.C.

Active
Parent organization
PMDENTAL SERVICES PC
Other names
PAUL HENNIS DDS -MANAL GERGES DDS
Organization subpart
Yes

Provider details

NPI number
Legal business name
PMDENTAL SERVICES PC
Authorized official
DR. PAUL HENNIS DDS (DENTIST)
(631) 748-6136
Entity
Organization

Contact information

Practice address
23520 147TH AVE, SUITE# 3, ROSEDALE, NY 11422-3293
(718) 723-4878
Mailing address
299 CANDLEWOOD PATH, DIX HILLS, NY 11746-8003
(631) 748-6136

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
037149
NY
1223G0001X
General Practice Dentistry
041974
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00739359
NY
05
01109815
NY
Enumeration date
12/18/2007
Last updated
12/18/2007
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