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General NPI Number Information
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NPI Number | 1427448877
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Entity Type | Organization
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Legal Business Name | KIDDSMILES PEDIATRIC DENTISTRY 4 PLLC
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Dates
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Enumeration Date | 01/23/2015
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 2211 MERRICK RD
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City | MERRICK
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State | NY
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Zip | 11566-4752
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Country | US
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Telephone | 516-365-5439
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Fax | 516-442-1020
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Provider Business Mailing Address
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Address Line | 2211 MERRICK RD
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City | MERRICK
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State | NY
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Zip | 11566-4752
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Country | US
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Telephone | 516-365-5439
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Fax | 516-442-1020
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | MRS. DANA HUTTER
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Credential |
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Telephone | 631-576-4254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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