| Joseph M. Licul, Dds, P.c. | |
|
8 N Main St Southampton NY 11968-3308 | |
| (631) 283-6591 | |
| Not Available |
| Full Name | Joseph M. Licul, Dds, P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8 N Main St, Southampton, New York |
| Authorized Official Name and Position | Joseph M Licul (PRESIDENT) |
| Authorized Official Contact | 9176862712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph M. Licul, Dds, P.c. 8 N Main St Southampton NY 11968-3308 Ph: (631) 283-6591 | Joseph M. Licul, Dds, P.c. 8 N Main St Southampton NY 11968-3308 Ph: (631) 283-6591 |
| NPI Number | 1457867483 |
|---|---|
| Provider Enumeration Date | 12/28/2017 |
| Last Update Date | 12/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457867483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 37608 (New York) | Primary |
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