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Individual

DR. CALOGERO VASSALLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
2500 NESCONSET HWY, BUILDING 19-B, STONY BROOK, NY 11790-2555
(631) 265-3656
Mailing address
2500 NESCONSET HWY, BUILDING 19-B, STONY BROOK, NY 11790-2555
(631) 265-3656

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050636
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
161750869
TAX ID#
NY
Enumeration date
03/09/2007
Last updated
02/23/2009
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