Individual
MELISSA ROSE KORNHABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1990 DEER PARK AVE, DEER PARK, NY 11729-3303
(631) 586-7654
Mailing address
3 FAIRWAY DR, GOSHEN, NY 10924-6929
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
LL-501-19
NV
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
062382
NY
Other
Enumeration date
03/26/2019
Last updated
06/09/2022
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