Organization
KENNETH A. PATICOFF, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH A PATICOFF DDS (OWNER)
(631) 667-0004
Entity
Organization
Contact information
Practice address
1992 DEER PARK AVE, DEER PARK, NY 11729-2701
(631) 667-0004
Mailing address
1992 DEER PARK AVE, DEER PARK, NY 11729-2701
(631) 667-0004
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/12/2007
Last updated
01/11/2013
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