# MISSIH DENTAL CARE & PERIODONTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700442746
- **Authorized official:** MR. COMLAN MARCEL MISSIH DDS, MPH, MA (OWNER-DENTIST)
- **Authorized official phone:** (607) 798-7188

## Contact information

- **Practice address:** 355 RIVERSIDE DRIVE, JOHNSON CITY, NY 13790
- **Practice address phone:** (607) 798-7188
- **Practice address fax:** (607) 797-8435
- **Mailing address:** 355 RIVERSIDE DRIVE, JOHNSON CITY, NY 13790
- **Mailing address phone:** (607) 798-7188
- **Mailing address fax:** (607) 797-8435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2019
- **Last updated:** 07/01/2022