Provider Demographics
NPI:1245478122
Name:VERDIER, ANCY (DMD)
Entity type:Individual
Prefix:DR
First Name:ANCY
Middle Name:
Last Name:VERDIER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:WAINSCOTT
Mailing Address - State:NY
Mailing Address - Zip Code:11975-0528
Mailing Address - Country:US
Mailing Address - Phone:631-537-1505
Mailing Address - Fax:
Practice Address - Street 1:384 MONTAUK HIGHWAY
Practice Address - Street 2:SUITE 4, BUILDING B
Practice Address - City:WAINSCOTT
Practice Address - State:NY
Practice Address - Zip Code:11975
Practice Address - Country:US
Practice Address - Phone:631-537-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051891-11223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics