Organization
JOSEPH M. LICUL, DDS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH M LICUL DDS (PRESIDENT)
(917) 686-2712
Entity
Organization
Contact information
Practice address
8 N MAIN ST, SOUTHAMPTON, NY 11968-3308
(631) 283-6591
Mailing address
8 N MAIN ST, SOUTHAMPTON, NY 11968-3308
(631) 283-6591
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
37608
NY
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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