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Individual

DR. MARTIN R. BOORIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1087 WESTMINSTER AVE, DIX HILLS, NY 11746-6340
(516) 776-0716
(631) 940-7227
Mailing address
P.O. BOX 107, HUNTINGTON STATION, NY 11746
(631) 940-3690
(631) 940-7227

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
039997
NY
122300000X
Dentist
22DIO1606400
NJ
122300000X
Dentist
7066
CT
1223D0004X
Dental Anesthesiology
Primary
039997
NY
1223D0004X
Dental Anesthesiology
220101606400
NJ
1223D0004X
Dental Anesthesiology
7006
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01020286
NY
01
P00023886
RAILROAD
NY
Enumeration date
06/22/2005
Last updated
06/19/2013
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