Dominick Anthony Suppo DDS

NPI 1679772040 - Dentist - 1223G0001X

NPI Details
NPI 1679772040
Gender Male
Enumeration Date 07/16/2007
Last Updated 07/16/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
299 GUYON AVENUE
STATEN ISLAND NY, 10306, US
Phone (718) 668-9214
Fax (718) 980-7017
Business Location
299 GUYON AVENUE
STATEN ISLAND NY, 10306, US
Phone (718) 668-9214
Fax (718) 980-7017
Toxanomy
Taxonomy Code 1223G0001X
License State New York
License Number 22980
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According to our database, Dr. Dominick Anthony Suppo DDS NPI is 1679772040, taxonomy code is 1223G0001X and license number is 22980, license state is located at New York. Dominick Anthony Suppo DDS physically located at 299 Guyon Avenue, Staten Island NY, 10306. NPI Number Dominick Anthony Suppo DDS has the Individual type.

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1679772040 NPI number is provided on an as is basis without warranty of any kind. 1679772040 is maintained by the National Plan & Provider Enumeration System. The contents of Dominick Anthony Suppo DDS are for informational purposes only.