Individual
CLARISA AMARILLAS GASTELUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS,MS
Contact information
Practice address
STONY BROOK SCHOOL OF DENTAL MEDICINE SOUTH DRIVE, STONY BROOK, NY 11794-0001
(631) 632-8631
Mailing address
127 WESTCHESTER HALL, STONY BROOK, NY 11794-8705
(631) 632-8631
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
000083
NY
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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