Individual
ESAU CRUZ GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
SUNY AT STONY BROOK AT STONY BROOK 151 WESTCHESTER HALL, STONY BROOK, NY 11794-0001
(845) 857-7574
Mailing address
110 GREENE AVE, PORT JEFFERSON STATION, NY 11776-4314
(845) 857-7574
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
063384
NY
Other
Enumeration date
02/27/2022
Last updated
07/31/2024
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