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Organization

BRADLEY S. PORTENOY, D.D.S,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA PATAKY (OFFICE MANAGER)
(516) 764-4386
Entity
Organization

Contact information

Practice address
371 MERRICK RD, SUITE 304, ROCKVILLE CENTRE, NY 11570-5359
(516) 764-4386
(516) 764-4389
Mailing address
371 MERRICK RD, SUITE 304, ROCKVILLE CENTRE, NY 11570-5359
(516) 764-4386
(516) 764-4389

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary

Other

Enumeration date
11/26/2014
Last updated
11/26/2014
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