Organization
PERIODONTAL & IMPLANT SURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY IENNA DDS (OWNER)
(516) 354-5228
Entity
Organization
Contact information
Practice address
393 FRANKLIN AVE, SUITE 103, FRANKLIN SQUARE, NY 11010-1222
(516) 354-5228
(516) 354-8006
Mailing address
393 FRANKLIN AVE, SUITE 103, FRANKLIN SQUARE, NY 11010-1222
(516) 354-5228
(516) 354-8006
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
040277
NY
Other
Enumeration date
10/11/2006
Last updated
08/11/2014
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