Organization
PETER H PRUDEN, D.D.S., P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER H PRUDEN D.D.S (ORAL SURGEON)
(631) 421-2471
Entity
Organization
Contact information
Practice address
124 MAIN ST, SUITE 2, HUNTINGTON, NY 11743-6922
(631) 421-2471
(631) 547-6809
Mailing address
124 MAIN ST, SUITE 2, HUNTINGTON, NY 11743-6922
(631) 421-2471
(631) 547-6809
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
034661
NY
Other
Enumeration date
04/20/2009
Last updated
04/20/2009
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