Provider Demographics
NPI:1649653528
Name:VARANO, SAL R (DDS)
Entity type:Individual
Prefix:DR
First Name:SAL
Middle Name:R
Last Name:VARANO
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 1:25-NASSAU BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY S
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-481-2380
Mailing Address - Fax:516-505-5347
Practice Address - Street 1:25-NASSAU BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY S
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-481-2380
Practice Address - Fax:516-505-5347
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042644122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist