Individual
DR. RITA SUSAN O'DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2500 NESCONSET HWY BLDG 18A, STONY BROOK, NY 11790-2563
(631) 751-1400
Mailing address
PO BOX 143, SAINT JAMES, NY 11780-0143
(631) 760-1048
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
059772
NY
1223G0001X
General Practice Dentistry
059772
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2017
Last updated
06/07/2022
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