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Organization
STONY BROOK FAMILY DENTISTRY PC
Active
Organization
STONY BROOK FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC BAUM DMD (PRESIDENT)
(631) 751-7645
Entity
Organization
Contact information
Practice address
207 HALLOCK RD, SUITE 5, STONY BROOK, NY 11790-3033
(631) 751-7645
(631) 751-4170
Mailing address
207 HALLOCK RD, SUITE 5, STONY BROOK, NY 11790-3033
(631) 751-7645
(631) 751-4170
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046703
NY
1223G0001X
General Practice Dentistry
047430
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
048062
NY
Other
Enumeration date
05/02/2007
Last updated
02/20/2008
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