Provider Demographics
NPI:1265689962
Name:BRANDOFF, PAUL M (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:BRANDOFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 JERICHO TURNPIKE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2808
Mailing Address - Country:US
Mailing Address - Phone:631-499-1212
Mailing Address - Fax:631-499-2389
Practice Address - Street 1:6080 JERICHO TURNPIKE
Practice Address - Street 2:SUITE 207
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2808
Practice Address - Country:US
Practice Address - Phone:631-499-1212
Practice Address - Fax:631-499-2389
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0263181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice