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Individual

DR. GEETHA BALAMURUGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
116 BROADWAY, AMITYVILLE, NY 11701-2797
(631) 264-2610
(631) 260-2612
Mailing address
116 BROADWAY, AMITYVILLE, NY 11701-2797
(631) 264-2610
(631) 260-2612

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049539
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02249278
NY
Enumeration date
03/25/2006
Last updated
07/08/2007
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