Individual
MR. MICHAEL REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
255 MASON AVE., STATEN ISLAND, NY 10305-3416
(718) 987-6543
(718) 987-6542
Mailing address
255 MASON AVE., STATEN ISLAND, NY 10305-3416
(718) 987-6543
(718) 987-6542
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
22DI01925000
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
39794
NY
Other
Enumeration date
01/02/2007
Last updated
10/25/2023
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