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General NPI Number Information
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NPI Number | 1649612532
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Entity Type | Organization
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Legal Business Name | MATTURRO DENTAL PC
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 3601 HEMPSTEAD TPKE 422
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City | LEVITTOWN
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State | NY
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Zip | 11756-1375
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Country | US
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Telephone | 516-735-7444
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Fax | 516-735-7516
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Provider Business Mailing Address
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Address Line | 3601 HEMPSTEAD TPKE 422
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City | LEVITTOWN
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State | NY
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Zip | 11756-1375
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Country | US
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Telephone | 516-735-7444
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Fax | 516-735-7516
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. LORI MATTURRO
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Credential | D.D.S.
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Telephone | 516-735-7444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 048688
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License Number State | NY
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