Individual
DR. KOMAL SURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
30 E 40TH ST RM 1001, NEW YORK, NY 10016-1206
(212) 683-1960
Mailing address
4220 24TH ST, LONG ISLAND CITY, NY 11101-4613
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
059259
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/01/2016
Last updated
11/30/2021
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