Individual
DANIEL ILYAICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
575 UNDERHILL BLVD STE 105, SYOSSET, NY 11791-3416
(516) 496-3880
Mailing address
575 UNDERHILL BLVD STE 105, SYOSSET, NY 11791-3416
(516) 496-3880
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
059750
NY
Other
Enumeration date
04/04/2017
Last updated
02/28/2022
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