Individual
HATEM HUSSEIN ELMISSIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1005 COMMACK RD, DIX HILLS, NY 11746
(631) 254-8240
(631) 254-8214
Mailing address
1005 COMMACK RD, DIX HILLS, NY 11746
(631) 254-8240
(631) 254-8214
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0517781
NY
1223G0001X
General Practice Dentistry
Primary
DDS109929
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02630308
—
NY
Enumeration date
02/07/2007
Last updated
06/20/2024
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