| White Hall Dental, Pc | |
|
27005 76th Ave New Hyde Park NY 11040-1402 | |
| (718) 470-7110 | |
| (718) 470-7393 |
| Full Name | White Hall Dental, Pc |
|---|---|
| Speciality | Dentist |
| Location | 27005 76th Ave, New Hyde Park, New York |
| Authorized Official Name and Position | Sharlene Bronstorph (DIRECTOR) |
| Authorized Official Contact | 5168503999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Hall Dental, Pc 27005 76th Ave New Hyde Park NY 11040-1402 Ph: (718) 470-7110 | White Hall Dental, Pc 27005 76th Ave New Hyde Park NY 11040-1402 Ph: (718) 470-7110 |
| NPI Number | 1376268821 |
|---|---|
| Provider Enumeration Date | 10/06/2022 |
| Last Update Date | 06/05/2023 |
| Medicare PECOS PAC ID | 2567820137 |
|---|---|
| Medicare Enrollment ID | O20230614002923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376268821 | NPI | - | NPPES |
| Provider Name | Peter Evan Protzel |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1700802980 PECOS PAC ID: 0749244630 Enrollment ID: I20041122000419 |
| Provider Name | David L Hirsch |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1124038427 PECOS PAC ID: 8325141310 Enrollment ID: I20070831000687 |
| Provider Name | Robert D Kelsch |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1972505493 PECOS PAC ID: 7618162140 Enrollment ID: I20101110000859 |
| Provider Name | John Fantasia |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1730258286 PECOS PAC ID: 9638368145 Enrollment ID: I20110114000560 |
| Provider Name | Joshua D Segal |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154595734 PECOS PAC ID: 4688829328 Enrollment ID: I20130301000128 |
| Provider Name | Hunter Martin |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1396035507 PECOS PAC ID: 2264702703 Enrollment ID: I20170717002180 |
| Provider Name | Kathleen M Schultz |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1043633365 PECOS PAC ID: 9830433937 Enrollment ID: I20190805001402 |
| Provider Name | Stephen Roth |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1083187538 PECOS PAC ID: 2769727460 Enrollment ID: I20210723000052 |
| Provider Name | Andrew R Salama |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1386788479 PECOS PAC ID: 5193895829 Enrollment ID: I20220126002599 |
| Provider Name | Monika Patel |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1457885923 PECOS PAC ID: 2769728229 Enrollment ID: I20230112002200 |
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