MEDICARE: SMILE AGAIN DENTAL PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0413541	NY

General Provider Information

NPI Number	:	1447423827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILE AGAIN DENTAL PC

Provider Business Mailing Address
First Line	:	2667 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-5520
Country	:	US
Telephone Number	:	718-934-0070
Fax Number	:	718-891-8949

Provider Business Practice Location Address
First Line	:	2667 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-5520
Country	:	US
Telephone Number	:	718-934-0070
Fax Number	:	718-891-8949

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MILA SORKIN
Credential	:	DDS
Telephone Number	:	718-934-0070

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	04/08/2008

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