Individual
DR. IVAN LUKACHYNETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
100 NICOLLS RD, STONY BROOK, NY 11790-3407
(631) 632-8900
Mailing address
100 NICOLLS RD, STONY BROOK, NY 11790-3407
(631) 632-8900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
058238
NY
Other
Enumeration date
02/09/2014
Last updated
08/26/2015
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