Individual provider · Type 1 NPI

Martin Dominger, DDS, MD

Oral and Maxillofacial Surgery (Dentist) · Port Jefferson Station, NY

NPI number 1689757668 Active

Practice location

5225 Nesconset Hwy, Suite 57
Port Jefferson Station, NY 11776-2053

Call (631) 474-4600 Map

Fax (631) 474-9056

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X044538 (NY)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1689757668

Martin Dominger, DDS, MD's National Provider Identifier is 1689757668, issued on Oct 23, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Port Jefferson Station, NY. The record was last updated on Jul 8, 2007.