Provider Demographics
NPI:1558573329
Name:AYROSO, CRISPIN ZAPANTA (DMD, PC)
Entity Type:Individual
Prefix:DR
First Name:CRISPIN
Middle Name:ZAPANTA
Last Name:AYROSO
Suffix:
Gender:M
Credentials:DMD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 S OCEAN AVE
Mailing Address - Street 2:SUITE 5 & 6
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-4548
Mailing Address - Country:US
Mailing Address - Phone:516-378-1780
Mailing Address - Fax:516-378-1795
Practice Address - Street 1:131 S OCEAN AVE
Practice Address - Street 2:SUITE 5 & 6
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-4548
Practice Address - Country:US
Practice Address - Phone:516-378-1780
Practice Address - Fax:516-378-1795
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0438571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice