Provider Demographics
NPI:1386101921
Name:PROHEALTH DENTAL PLLC
Entity type:Organization
Organization Name:PROHEALTH DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:KARNOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-969-9999
Mailing Address - Street 1:100 MERRICK RD STE 106E
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4801
Mailing Address - Country:US
Mailing Address - Phone:516-766-5558
Mailing Address - Fax:
Practice Address - Street 1:100 MERRICK RD STE 106E
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4801
Practice Address - Country:US
Practice Address - Phone:516-766-5558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty