Individual
PANAGIOTIS EMMANOUILIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
345 E 24TH ST, NEW YORK, NY 10010-4020
(646) 637-2604
Mailing address
412 E 55TH ST APT 10C, NEW YORK, NY 10022-5115
(646) 637-2604
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
000091
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000091
—
NY
Enumeration date
04/23/2018
Last updated
05/02/2018
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