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Organization

THOMAS MORTILLARO DDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS MORTILLARO DDS (PRESIDENT)
(718) 491-3901
Entity
Organization

Contact information

Practice address
9602 4TH AVE, BROOKLYN, NY 11209-7851
(718) 491-3901
Mailing address
9602 4TH AVE, BROOKLYN, NY 11209-7851

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
045148
NY

Other

Enumeration date
01/18/2010
Last updated
01/18/2010
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