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General NPI Number Information
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NPI Number | 1972578904
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Entity Type | Individual
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Provider Name | DORIS ORTIZ DDS
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Gender | Female
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 35A GUY LOMBARDO AVE
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City | FREEPORT
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State | NY
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Zip | 11520-3604
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Country | US
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Telephone | 516-546-6709
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Fax | 516-546-0189
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Provider Business Mailing Address
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Address Line | 35A GUY LOMBARDO AVE
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City | FREEPORT
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State | NY
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Zip | 11520-3604
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Country | US
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Telephone | 516-546-6709
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Fax | 516-379-1013
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 042609
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License Number State | NY
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