| Shore Smiles Dental, Pc | |
|
875 N Broadway Massapequa NY 11758-2344 | |
| (516) 797-0300 | |
| Not Available |
| Full Name | Shore Smiles Dental, Pc |
|---|---|
| Speciality | Dentist |
| Location | 875 N Broadway, Massapequa, New York |
| Authorized Official Name and Position | Jigar S Gandhi (OWNER) |
| Authorized Official Contact | 5167970300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Smiles Dental, Pc 875 N Broadway Massapequa NY 11758-2344 Ph: (516) 797-0300 | Shore Smiles Dental, Pc 875 N Broadway Massapequa NY 11758-2344 Ph: (516) 797-0300 |
| NPI Number | 1487054938 |
|---|---|
| Provider Enumeration Date | 09/02/2014 |
| Last Update Date | 07/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487054938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 055149 (New York) | Primary |
| 261QD0000X | Clinic/center - Dental | 055149 (New York) | Secondary |
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