| Staten Island Smile Dental Pllc | |
|
621 Katan Ave Staten Island NY 10312-3422 | |
| (718) 948-4000 | |
| (718) 948-4001 |
| Full Name | Staten Island Smile Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 621 Katan Ave, Staten Island, New York |
| Authorized Official Name and Position | Rocco Diantonio (MANAGING MEMBER) |
| Authorized Official Contact | 7189484000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Staten Island Smile Dental Pllc 621 Katan Ave Staten Island NY 10312-3422 Ph: (718) 948-4000 | Staten Island Smile Dental Pllc 621 Katan Ave Staten Island NY 10312-3422 Ph: (718) 948-4000 |
| NPI Number | 1639622020 |
|---|---|
| Provider Enumeration Date | 08/02/2016 |
| Last Update Date | 08/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639622020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0555071 (New York) | Primary |
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