Individual
DR. GLEN J PICHICHERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
224 LONG BEACH BLVD, LONG BEACH, NY 11561-4230
(516) 431-2333
Mailing address
224 LONG BEACH BLVD, LONG BEACH, NY 11561-4230
(516) 431-2333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
38761
NY
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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