Individual
DR. ROBERT J LICUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
959 BRUSH HOLLOW RD, WESTBURY, NY 11590-1778
(516) 333-5900
(516) 333-5868
Mailing address
959 BRUSH HOLLOW RD, WESTBURY, NY 11590-1778
(516) 333-5900
(516) 333-5868
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
044656
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02071410
—
NY
Enumeration date
11/23/2005
Last updated
04/17/2008
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