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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003805748 | NPPES |
| New York | Other | 040425 | LIC # |
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