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General NPI Number Information
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NPI Number | 1902024995
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Entity Type | Organization
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Legal Business Name | BERRY HILL DENTISTRY PC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 26 BERRY HILL RD
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City | SYOSSET
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State | NY
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Zip | 11791-2623
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Country | US
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Telephone | 516-921-1717
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Fax | 516-921-3346
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Provider Business Mailing Address
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Address Line | 26 BERRY HILL ROAD
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City | SYOSSET
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State | NY
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Zip | 11791-2623
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Country | US
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Telephone | 516-921-1717
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Fax | 516-921-3346
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN WILLIAM COTTONE
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Credential | D.M.D.
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Telephone | 516-921-1717
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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 | 0419471
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License Number State | NY
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