Individual
DR. MICHAEL PROOTHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
207 HALLOCK RD STE 2, STONY BROOK, NY 11790-3072
(631) 675-9601
(631) 675-9602
Mailing address
207 HALLOCK RD STE 2, STONY BROOK, NY 11790-3072
(631) 675-9601
(631) 675-9602
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
051735
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
260012
NY
Other
Enumeration date
09/30/2008
Last updated
02/29/2024
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