Port Jefferson Dental Group P. C.
NPI #1093960890 in Port Jefferson, New York
Provider Information
- NPI Number
- 1093960890
- Entity Type
- Organization
- Organization Name
- Port Jefferson Dental Group P. C.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 20, 2008
- Last Updated
- Nov 20, 2008
Practice Location
- Address
- 602 MAIN ST
- City
- Port Jefferson
- State
- New York
- ZIP Code
- 11777-2203
- Phone
- (631) 473-0605
Authorized Official
- Name
- DR. JOHN C RUTTER, D.M.D
- Title
- PRESIDENT
- Phone
- (631) 473-1511
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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