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Individual

DR. SHANTANU LAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
220 RIVERSIDE BLVD, HAPPY TEETH NY LLC, NEW YORK, NY 10069-1001
(212) 810-6562
Mailing address
400 W 63RD ST, 2404, NEW YORK, NY 10069-0434

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
05 056328
NY

Other

Enumeration date
07/30/2008
Last updated
04/02/2015
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