Organization
LOURDES DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PIKUS DDS (OWNER)
15164415152
Entity
Organization
Contact information
Practice address
1185 NORTHERN BLVD, MANHASSET, NY 11030-3017
(151) 644-1515
Mailing address
1185 NORTHERN BLVD, MANHASSET, NY 11030-3017
(151) 644-1515
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
122400000X
Denturist
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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