| Steven R Izzo DDS PC | |
|
6853 Fresh Pond Rd Ridgewood NY 11385-5263 | |
| (718) 821-2545 | |
| (718) 418-2809 |
| Full Name | Steven R Izzo DDS PC |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 6853 Fresh Pond Rd, Ridgewood, New York |
| Authorized Official Name and Position | Steven R Izzo (OWNER) |
| Authorized Official Contact | 7188212545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Steven R Izzo DDS PC 6853 Fresh Pond Rd Ridgewood NY 11385-5263 Ph: (718) 821-2545 | Steven R Izzo DDS PC 6853 Fresh Pond Rd Ridgewood NY 11385-5263 Ph: (718) 821-2545 |
| NPI Number | 1962655209 |
|---|---|
| Provider Enumeration Date | 10/30/2008 |
| Last Update Date | 11/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962655209 | NPI | - | NPPES |
| 01594536 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 042245 (New York) | Primary |
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