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General NPI Number Information
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NPI Number | 1780822783
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Entity Type | Organization
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Legal Business Name | ALL ABOUT SMILES PEDIATRIC DENTISTRY, PC
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 5036 JERICHO TPKE STE 307
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City | COMMACK
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State | NY
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Zip | 11725-2812
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Country | US
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Telephone | 631-670-6035
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Fax |
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Provider Business Mailing Address
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Address Line | 10 PINE RIDGE DR
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City | SMITHTOWN
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State | NY
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Zip | 11787-4024
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Country | US
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Telephone | 631-670-6035
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. PATRICIA I. JUAREZ
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Credential | D.M.D.
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Telephone | 631-670-6035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 049452-1
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License Number State | NY
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