Healthcare Provider Details

I. General information

NPI: 1023314713
Provider Name (Legal Business Name): ALL ABOUT SMILES DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 LONG BEACH RD
OCEANSIDE NY
11572-5424
US

IV. Provider business mailing address

3471 LONG BEACH RD
OCEANSIDE NY
11572-5424
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-5800
  • Fax: 516-536-0186
Mailing address:
  • Phone: 516-536-5800
  • Fax: 516-536-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number047087
License Number StateNY

VIII. Authorized Official

Name: DR. ADAM DAVID SHATZ
Title or Position: CO-OWNER
Credential: D.D.S.
Phone: 516-536-5800