Individual
DR. MARTIN DOMINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,MD
Contact information
Practice address
5225 NESCONSET HWY, SUITE 57, PORT JEFFERSON STATION, NY 11776-2053
(631) 474-4600
(631) 474-9056
Mailing address
5225 NESCONSET HWY, SUITE 57, PORT JEFFERSON STATION, NY 11776-2053
(631) 474-4600
(631) 474-9056
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
044538
NY
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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