Provider Demographics
NPI:1578648721
Name:POBINER, SHAWN GARRETT (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:GARRETT
Last Name:POBINER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3366 PARK AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3738
Mailing Address - Country:US
Mailing Address - Phone:516-825-6655
Mailing Address - Fax:516-826-8542
Practice Address - Street 1:3366 PARK AVE
Practice Address - Street 2:STE 202
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3738
Practice Address - Country:US
Practice Address - Phone:516-825-6655
Practice Address - Fax:516-826-8542
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY04949911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics