Healthcare Provider Details

I. General information

NPI: 1932188950
Provider Name (Legal Business Name): DAVID MARVIN EPSTEIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 20 MERRICK BLVD
ST ALBANS NY
11433
US

IV. Provider business mailing address

6 CARUSO CT
GLEN COVE NY
11542-3138
US

V. Phone/Fax

Practice location:
  • Phone: 718-739-9662
  • Fax: 718-206-3033
Mailing address:
  • Phone: 516-674-5101
  • Fax: 516-674-5101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0269151
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: