Individual
DR. ANTONIO ARDISANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8710 GRAND AVE, ELMHURST, NY 11373-4444
(718) 429-8300
(516) 822-2396
Mailing address
37 TRIANGLE RD, LIBERTY, NY 12754
(845) 292-3900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
034831
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00487994
—
NY
Enumeration date
05/29/2007
Last updated
08/08/2019
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