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General NPI Number Information
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NPI Number | 1497562896
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Entity Type | Organization
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Legal Business Name | TINY TEETH PEDIATRIC DENTISTRY PC
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 08/02/2025
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Provider Practice Location Address
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Address Line | 297 MINEOLA BLVD
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City | MINEOLA
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State | NY
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Zip | 11501-1502
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Country | US
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Telephone | 516-272-4450
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Fax | 516-272-4942
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Provider Business Mailing Address
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Address Line | 59 TITUS AVE
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City | CARLE PLACE
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State | NY
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Zip | 11514-1312
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Country | US
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Telephone | 516-350-4502
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTONIA ROSE MAURO
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Credential | DDS
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Telephone | 516-350-4502
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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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