Individual
LOUIS TONY PANNULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, M.S.
Contact information
Practice address
397 WILLIS AVE, WILLISTON PARK, NY 11596-2208
(516) 294-1780
(516) 294-0748
Mailing address
397 WILLIS AVE, WILLISTON PARK, NY 11596-2208
(516) 294-1780
(516) 294-0748
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
045189
NY
Other
Enumeration date
10/13/2006
Last updated
08/27/2024
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