| Lakeville Dental Group. P.c. | |
|
1 Hollow Ln Suite 108 New Hyde Park NY 11042-1215 | |
| (516) 869-3400 | |
| (516) 869-3403 |
| Full Name | Lakeville Dental Group. P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1 Hollow Ln, New Hyde Park, New York |
| Authorized Official Name and Position | Kenneth Micheal Devita (SENIOR PARTNER) |
| Authorized Official Contact | 5168693400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeville Dental Group. P.c. 1 Hollow Ln Suite 108 New Hyde Park NY 11042-1215 Ph: (516) 869-3400 | Lakeville Dental Group. P.c. 1 Hollow Ln Suite 108 New Hyde Park NY 11042-1215 Ph: (516) 869-3400 |
| NPI Number | 1568608248 |
|---|---|
| Provider Enumeration Date | 12/30/2008 |
| Last Update Date | 12/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568608248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 031697 (New York) | Primary |
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