Individual
DANIEL MARC GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11401 201ST ST, SAINT ALBANS, NY 11412-2810
(718) 464-2138
(718) 464-4358
Mailing address
11401 201ST ST, SAINT ALBANS, NY 11412-2810
(718) 464-2138
(718) 464-4358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
033015-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00842484
—
NY
05
—
243
—
NY
01
—
A7551
HEALTHPLEX SITE #
NY
Enumeration date
02/14/2007
Last updated
07/09/2007
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