Provider Demographics
NPI:1255320412
Name:WYNTER, OVRAL J (DDS)
Entity Type:Individual
Prefix:
First Name:OVRAL
Middle Name:J
Last Name:WYNTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-6948
Mailing Address - Country:US
Mailing Address - Phone:718-294-3725
Mailing Address - Fax:718-466-0782
Practice Address - Street 1:1624 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-6948
Practice Address - Country:US
Practice Address - Phone:718-294-3725
Practice Address - Fax:718-466-0782
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048772-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist