Individual
DR. BRIAN MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2500 NESCONSET HWY BLDG 18A, STONY BROOK, NY 11790-2563
(516) 313-6949
Mailing address
2500 NESCONSET HWY BLDG 18A, STONY BROOK, NY 11790-2563
(516) 313-6949
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
054959-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2009
Last updated
06/07/2012
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