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Individual

SLAVA SHAPIRO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MD

Contact information

Practice address
118 GREENWAY DR S, SYOSSET, NY 11791-3854
(917) 837-8023
Mailing address
167 FROEHLICH FARM BLVD, WOODBURY, NY 11797-2906
(917) 837-8023

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
049812-1
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
049812-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02491569
NY
Enumeration date
07/11/2007
Last updated
07/05/2010
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