Organization
LONG ISLAND DENTISTRY PLLC
Active
Organization
LONG ISLAND DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRA D KOEPPEL DDS (OWNER)
(631) 689-1800
Entity
Organization
Contact information
Practice address
126 GNARLED HOLLOW RD, EAST SETAUKET, NY 11733-1975
(631) 689-9777
(631) 689-2108
Mailing address
126 GNARLED HOLLOW RD, EAST SETAUKET, NY 11733-1975
(631) 689-9777
(631) 689-2108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
038668
NY
Other
Enumeration date
02/04/2015
Last updated
12/12/2017
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