Individual
DR. ELLIOT JON FIDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
100 MANETTO HILL RD, 203, PLAINVIEW, NY 11803-1311
(516) 931-7001
Mailing address
100 MANETTO HILL RD, 203, PLAINVIEW, NY 11803-1311
(516) 931-7001
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
033201
NY
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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