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Individual

DR. ROBERT DAVID BLANK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
51A N. FERRY RD., SHELTER ISLAND, NY 11964-0715
(631) 749-2646
Mailing address
56 N. CARTWRIGHT RD., POB 715, SHELTER ISLAND, NY 11964-0715
(631) 749-2117

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
24831
NY

Other

Enumeration date
10/04/2006
Last updated
07/08/2007
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