Individual
DR. JOHN E. CHICVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1044 NORTHERN BLVD., SUITE 306, ROSLYN, NY 11576
(516) 466-1177
(516) 466-0763
Mailing address
1044 NORTHERN BLVD., SUITE 306, ROSLYN, NY 11576
(516) 466-1177
(516) 466-0763
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
042819
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01244655
—
NY
Enumeration date
08/02/2006
Last updated
11/19/2014
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