Pediatric Dentistry of Suffolk County

NPI #1407118540 in Commack, New York

Provider Information

NPI Number: 1407118540
Entity Type: Organization
Organization Name: Pediatric Dentistry of Suffolk County
Primary Specialty: Dentist
Enumeration Date: Jun 14, 2012
Last Updated: Jun 14, 2012

Practice Location

Address: 2171 JERICHO TPKE
Address 2: SUITE 145
City: Commack
State: New York
ZIP Code: 11725-2937
Phone: (631) 486-6364

Authorized Official

Name: DR. MICHAEL IOANNOU
Title: PEDIATRIC DENTIST
Phone: (631) 486-6364

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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