| Your Smile Dental Of Hauppauge | |
|
521 Route 111 Ste 106 Hauppauge NY 11788-4358 | |
| (631) 361-6605 | |
| Not Available |
| Full Name | Your Smile Dental Of Hauppauge |
|---|---|
| Speciality | Dentist |
| Location | 521 Route 111 Ste 106, Hauppauge, New York |
| Authorized Official Name and Position | Lisa Sandman (OFFICE MANAGER) |
| Authorized Official Contact | 6314132912 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Smile Dental Of Hauppauge 521 Route 111 Ste 106 Hauppauge NY 11788-4358 Ph: (631) 361-6605 | Your Smile Dental Of Hauppauge 521 Route 111 Ste 106 Hauppauge NY 11788-4358 Ph: (631) 361-6605 |
| NPI Number | 1053827782 |
|---|---|
| Provider Enumeration Date | 12/18/2017 |
| Last Update Date | 10/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053827782 | NPI | - | NPPES |
| 03269418 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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