Organization
LONG BEACH IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLEN SHANOCK DDS (OWNER)
(516) 431-0727
Entity
Organization
Contact information
Practice address
120 W PARK AVE, SUITE 306, LONG BEACH, NY 11561-3301
(516) 431-0727
Mailing address
120 W PARK AVE, SUITE 306, LONG BEACH, NY 11561-3301
(516) 431-0727
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/26/2008
Last updated
01/26/2008
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