Organization
STONY BROOK DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT REINER D.D.S (EXECUTIVE DIRECTOR)
(631) 632-8971
Entity
Organization
Contact information
Practice address
SULLIVAN HALL ROOM 170, FACULTY PRACTICE, STONY BROOK, NY 11794-8705
(631) 632-8971
(631) 632-7658
Mailing address
SULLIVAN HALL ROOM 170, FACULTY PRACTICE, STONY BROOK, NY 11794-8705
(631) 632-8971
(631) 632-7658
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
031804-1
NY
1223P0221X
Pediatric Dentistry
043965-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00675654
—
NY
05
—
01470777
—
NY
Enumeration date
03/11/2008
Last updated
03/11/2008
Update your record
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