Individual
PETER EVAN PROTZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
4277 HEMPSTEAD TPKE, SUITE 214, BETHPAGE, NY 11714-5709
(516) 735-6505
(516) 735-3326
Mailing address
4277 HEMPSTEAD TURNPIKE, SUITE 214, BETHPAGE, NY 11714
(516) 735-6505
(516) 735-3326
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
047168
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
047168
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02339499
—
NY
Enumeration date
07/14/2006
Last updated
03/12/2025
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