Individual
KAMRAN SANANDAJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1745 UNION BLVD, BAY SHORE, NY 11706-7937
(631) 968-5995
(631) 968-5996
Mailing address
1745 UNION BLVD, BAY SHORE, NY 11706-7937
(631) 968-5995
(631) 968-5996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046079
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01660517
—
NY
Enumeration date
11/18/2005
Last updated
12/10/2012
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