Organization
GEETHA BALAMURUGAN,D.D.S.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEETHA BALAMURUGAN D.D.S. (PRESIDENT)
(631) 264-2610
Entity
Organization
Contact information
Practice address
116 BROADWAY, AMITYVILLE, NY 11701-2797
(631) 264-2610
(631) 264-2612
Mailing address
116 BROADWAY, AMITYVILLE, NY 11701-2797
(631) 264-2610
(631) 264-2612
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049539-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02249278
—
NY
Enumeration date
06/03/2007
Last updated
08/22/2020
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