Organization
BLACK HALL DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6058
Entity
Organization
Contact information
Practice address
400 COMMUNITY DR, MANHASSET, NY 11030-3815
(516) 562-4525
(516) 562-2470
Mailing address
400 COMMUNITY DR, MANHASSET, NY 11030-3815
(516) 562-4525
(516) 562-2470
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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