| Stony Brook Dental Associates | |
|
Sullivan Hall Room 170 Faculty Practice Stony Brook NY 11794-8705 | |
| (631) 632-8971 | |
| (631) 632-7658 |
| Full Name | Stony Brook Dental Associates |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | Sullivan Hall Room 170, Stony Brook, New York |
| Authorized Official Name and Position | Robert Reiner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6316328971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stony Brook Dental Associates Sullivan Hall Room 170 Faculty Practice Stony Brook NY 11794-8705 Ph: (631) 632-8971 | Stony Brook Dental Associates Sullivan Hall Room 170 Faculty Practice Stony Brook NY 11794-8705 Ph: (631) 632-8971 |
| NPI Number | 1265602874 |
|---|---|
| Provider Enumeration Date | 03/11/2008 |
| Last Update Date | 03/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265602874 | NPI | - | NPPES |
| 01470777 | Medicaid | NY | |
| 00675654 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 043965-1 (New York) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 031804-1 (New York) | Primary |
Stony Brook Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: State University At Stony Brk, School Of Dental Medicine 170 Sullivan Hall, Stony Brook, NY 11794 Phone: 631-632-8971 | |
Stony Brook Oral And Facial Surgery Pc Dental Clinic Medicare: Medicare Enrolled Practice Location: 207 Hallock Rd, Suite 2, Stony Brook, NY 11790 Phone: 631-675-9601 Fax: 631-675-9602 | |
Stony Brook Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Nesconset Hwy, Suite 11, Stony Brook, NY 11790 Phone: 631-751-7171 | |
Advanced Endodontics Of Long Island, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790 Phone: 631-751-1400 Fax: 631-751-1996 |