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General NPI Number Information
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NPI Number | 1780183079
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Entity Type | Individual
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Provider Name | BRYCE MAXWELL LEDNER DDS
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Gender | Male
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 403 FORT SALONGA RD
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City | NORTHPORT
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State | NY
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Zip | 11768-3045
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Country | US
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Telephone | 631-261-4477
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Fax | 631-261-0765
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Provider Business Mailing Address
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Address Line | 51 HARBOR PARK DR
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City | CENTERPORT
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State | NY
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Zip | 11721-1640
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Country | US
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Telephone | 516-356-6670
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 060947
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License Number State | NY
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