Organization
PREMIER ENDODONTICS OF PATCHOGUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHISH SAHASRABUDHE D.M.D (OWNER)
(516) 222-1822
Entity
Organization
Contact information
Practice address
44 MEDFORD AVENUE, PATCHOGUE, NY 11772
(631) 447-6060
(631) 447-7088
Mailing address
44 MEDFORD AVENUE, PATCHOGUE, NY 11772
(631) 447-6060
(631) 447-7088
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
NY
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
NY
1223P0300X
Periodontics
—
NY
Other
Enumeration date
05/29/2018
Last updated
05/31/2018
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