Healthcare Provider Details

I. General information

NPI: 1730402124
Provider Name (Legal Business Name): HOWARD M. TICHLER DDS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2010
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 MONTAUK HIGHWAY
WEST ISLIP NY
11795-4920
US

IV. Provider business mailing address

725 MONTAUK HIGHWAY
WEST ISLIP NY
11795-4920
US

V. Phone/Fax

Practice location:
  • Phone: 631-661-6202
  • Fax: 631-661-7269
Mailing address:
  • Phone: 631-661-6202
  • Fax: 631-661-7269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN E. SCHECTER
Title or Position: OWNER
Credential: D.D.S.
Phone: 631-661-6202