| Peter H Pruden, D.d.s., P.c | |
|
124 Main St Suite 2 Huntington NY 11743-6922 | |
| (631) 421-2471 | |
| (631) 547-6809 |
| Full Name | Peter H Pruden, D.d.s., P.c |
|---|---|
| Speciality | Dentist |
| Location | 124 Main St, Huntington, New York |
| Authorized Official Name and Position | Peter H Pruden (ORAL SURGEON) |
| Authorized Official Contact | 6314212471 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter H Pruden, D.d.s., P.c 124 Main St Suite 2 Huntington NY 11743-6922 Ph: (631) 421-2471 | Peter H Pruden, D.d.s., P.c 124 Main St Suite 2 Huntington NY 11743-6922 Ph: (631) 421-2471 |
| NPI Number | 1114160207 |
|---|---|
| Provider Enumeration Date | 04/20/2009 |
| Last Update Date | 04/20/2009 |
| Medicare PECOS PAC ID | 8325197080 |
|---|---|
| Medicare Enrollment ID | O20090529000061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114160207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 034661 (New York) | Primary |
| Provider Name | Peter H Pruden |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1013087790 PECOS PAC ID: 2062569080 Enrollment ID: I20090409000069 |
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