Individual
DR. GLEN SHANOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
120 W PARK AVE, SUITE 301, LONG BEACH, NY 11561-3301
(516) 431-5855
Mailing address
120 W PARK AVE, SUITE 301, LONG BEACH, NY 11561-3301
(516) 431-5855
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
045836
NY
Other
Enumeration date
12/07/2005
Last updated
07/08/2007
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