Individual
VISHAAL AGRAWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23 BOND ST STE 8, GREAT NECK, NY 11021
(951) 751-5779
Mailing address
4540 CENTER BLVD APT 2602, LONG ISLAND CITY, NY 11109-5815
(951) 751-5779
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
059956
NY
Other
Enumeration date
03/14/2012
Last updated
08/23/2018
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