Provider Demographics
NPI:1033749916
Name:YEHUDA MARCIANO DDS PC
Entity Type:Organization
Organization Name:YEHUDA MARCIANO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YEHUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-295-3733
Mailing Address - Street 1:932 BROADWAY STE 1
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1723
Mailing Address - Country:US
Mailing Address - Phone:516-295-3733
Mailing Address - Fax:
Practice Address - Street 1:932 BROADWAY STE 1
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1723
Practice Address - Country:US
Practice Address - Phone:516-295-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty