Individual
DR. SCOTT A SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
510 BROADHOLLOW RD, SUITE 130, MELVILLE, NY 11747-3671
(631) 465-0300
(631) 271-1593
Mailing address
510 BROADHOLLOW RD, SUITE 130, MELVILLE, NY 11747-3671
(631) 465-0300
(631) 271-1593
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
045923
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02145962
—
NY
Enumeration date
03/29/2006
Last updated
01/11/2013
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