Provider Demographics
NPI:1902075369
Name:AVRASH, EUGENE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:R
Last Name:AVRASH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SMITHTOWN BYP
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2524
Mailing Address - Country:US
Mailing Address - Phone:631-265-6262
Mailing Address - Fax:
Practice Address - Street 1:111 SMITHTOWN BYP
Practice Address - Street 2:SUITE 203
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2524
Practice Address - Country:US
Practice Address - Phone:631-265-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist