Branca, Robert

Branca, Robert is an sole proprietor health care provider with primary practice located at 112 Alexander Ave Suite A, Lake Grove NY 11755-0429. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Branca, Robert can be contacted via phone (631) 265-6655.

Contact Information

Primary practice address
112 Alexander Ave Suite A Lake Grove NY 11755-0429
Phone: (631) 265-6655
Fax: (631) 265-9735
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 040425 New York

Profile Details

NPI number 1003805748
LBN Legal business name Branca, Robert
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 16th, 2005
Last updated Apr 2nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003805748 NPPES
New York Other 040425 LIC #

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