Individual
DR. SAMUEL POLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
622 W 168TH ST, ORTHODONTICS DEPARTMENT, NEW YORK, NY 10032-3720
(212) 305-7990
Mailing address
622 W 168TH ST, ORTHODONTICS DEPARTMENT, NEW YORK, NY 10032-3720
(212) 305-7990
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
057407
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/17/2014
Last updated
01/05/2015
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