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Individual

DR. GLENN CHARLES SIMONELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1 HOLLOW LN, SUITE 202, NEW HYDE PARK, NY 11042-1215
(516) 627-0999
Mailing address
1 HOLLOW LN, SUITE 202, NEW HYDE PARK, NY 11042-1215
(516) 627-0999

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
421341
NY

Other

Enumeration date
10/02/2008
Last updated
10/02/2008
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