Organization
MADISON DENTAL MANAGEMENT ASSOCIATES LLC
Active
Other names
Bay Dental Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE LOUIS ANTENUCCI DDS (PRESIDENT)
(631) 665-8484
Entity
Organization
Contact information
Practice address
1579 BRENTWOOD RD, BAY SHORE, NY 11706-3225
(631) 665-8484
(631) 665-3953
Mailing address
1579 BRENTWOOD RD, BAY SHORE, NY 11706-3225
(631) 665-8484
(631) 665-3953
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
038340-1
NY
Other
Enumeration date
04/26/2017
Last updated
04/26/2017
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