Individual
DR. LAWRENCE L. MAILLOUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
775 PARK AVE, SUITE 135, HUNTINGTON, NY 11743
(631) 549-3377
(631) 549-3359
Mailing address
775 PARK AVE., SUITE 135, HUNTINGTON, NY 11743
(631) 549-3377
(631) 549-3359
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
032904
NY
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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