Smith Haven Dentistry, Pllc
NPI #1144608936 in Lake Grove, New York
Provider Information
- NPI Number
- 1144608936
- Entity Type
- Organization
- Organization Name
- Smith Haven Dentistry, Pllc
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- May 12, 2015
- Last Updated
- May 12, 2015
Practice Location
- Address
- 2233 NESCONSET HWY
- Address 2
- STE #101
- City
- Lake Grove
- State
- New York
- ZIP Code
- 11755-1000
- Phone
- (631) 588-3636
Authorized Official
- Name
- DR. THOMAS R DOUGLAS
- Title
- SOLE MEMBER
- Phone
- (631) 588-3636
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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