| Harborbay Dental | |
|
160 Brentwood Rd Bay Shore NY 11706-6948 | |
| (631) 666-0427 | |
| (631) 647-7687 |
| Full Name | Harborbay Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 160 Brentwood Rd, Bay Shore, New York |
| Authorized Official Name and Position | Steven Anthony Grandillo (DENTIST) |
| Authorized Official Contact | 6316660427 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harborbay Dental 160 Brentwood Rd Bay Shore NY 11706-6948 Ph: (631) 666-0427 | Harborbay Dental 160 Brentwood Rd Bay Shore NY 11706-6948 Ph: (631) 666-0427 |
| NPI Number | 1932489192 |
|---|---|
| Provider Enumeration Date | 08/19/2011 |
| Last Update Date | 08/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932489192 | NPI | - | NPPES |
| 02699012 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 048345-1 (New York) | Primary |
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