Provider Demographics
NPI:1306960901
Name:SOUTH SHORE ENDODONTICS PC
Entity type:Organization
Organization Name:SOUTH SHORE ENDODONTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:BROWDY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-599-7111
Mailing Address - Street 1:483 SCRANTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563
Mailing Address - Country:US
Mailing Address - Phone:516-599-7111
Mailing Address - Fax:516-593-0006
Practice Address - Street 1:483 SCRANTON AVENUE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563
Practice Address - Country:US
Practice Address - Phone:516-599-7111
Practice Address - Fax:516-593-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0308091223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty