Lake Grove Dentistry PC
NPI #1174075519 in Lake Grove, New York
Provider Information
- NPI Number
- 1174075519
- Entity Type
- Organization
- Organization Name
- Lake Grove Dentistry PC
- Primary Specialty
- Dentist
- Enumeration Date
- Nov 2, 2016
- Last Updated
- Nov 2, 2016
Practice Location
- Address
- 1014 HAWKINS AVE
- City
- Lake Grove
- State
- New York
- ZIP Code
- 11755-1600
- Phone
- (631) 467-7878
Authorized Official
- Name
- MEENA SHAH
- Title
- OWNER
- Phone
- (631) 467-7878
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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