Individual
KEVIN SCHACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.M.SC.
Contact information
Practice address
3010 WESTCHESTER AVE, SUITE 403, PURCHASE, NY 10577-2535
(914) 481-1816
Mailing address
3010 WESTCHESTER AVE, SUITE 403, PURCHASE, NY 10577-2535
(914) 481-1816
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
051951-1
NY
Other
Enumeration date
05/30/2012
Last updated
05/30/2012
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