Individual
DR. DWAYNE MICHAEL BODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
795 FLUSHING AVE, BROOKLYN, NY 11206-4107
(718) 963-9500
(718) 963-9553
Mailing address
114108 227TH ST, CAMBRIA HEIGHTS, NY 11411-1329
(917) 714-2637
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053605
NY
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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