Organization
DISTINCTIVE DENTAL SERVICES OF NEW YORK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH HARRIS EPSTEIN DDS (PRESIDENT)
(516) 487-8110
Entity
Organization
Contact information
Practice address
173 E SHORE RD, SUITE 201, GREAT NECK, NY 11023-2415
(516) 487-8110
(516) 487-8394
Mailing address
173 EAST SHORE RD, SUITE 201, GREAT NECK, NY 11023
(516) 487-8110
(516) 487-8394
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
054882
NY
1223D0004X
Dental Anesthesiology
054882
NY
1223D0004X
Dental Anesthesiology
34227
NY
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/20/2007
Last updated
06/18/2013
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