Individual
DR. DANIEL MOEZINIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15 FAIRFIELD RD, GREAT NECK, NY 11024-1414
(516) 641-2643
Mailing address
15 FAIRFIELD RD, GREAT NECK, NY 11024-1414
(516) 641-2643
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
043896
NY
1223P0700X
Prosthodontics
043896
NY
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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