Walters, Jeffrey Mark

Walters, Jeffrey Mark is an individual health care provider with primary practice located at 116 Broadway , Amityville NY 11701-2797. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Walters, Jeffrey Mark can be contacted via phone (631) 264-2610.

Contact Information

Primary practice address
116 Broadway Amityville NY 11701-2797
Phone: (631) 264-2610
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 028643 New York

Profile Details

NPI number 1942298062
LBN Legal business name Walters, Jeffrey Mark
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Jul 8th, 2007 - about 17 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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