Individual
DR. FANNY R SHAULOV VAINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
609 MAIN ST, SPARKILL, NY 10976-1209
(845) 359-0288
Mailing address
609 MAIN ST, SPARKILL, NY 10976-1209
(845) 359-0288
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
062388-01
NY
Other
Enumeration date
04/08/2020
Last updated
10/04/2023
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