South Shore Long Island Periodontics and Implantology

NPI #1417755596 in Wantagh, New York

Provider Information

NPI Number: 1417755596
Entity Type: Organization
Organization Name: South Shore Long Island Periodontics and Implantology
Primary Specialty: Dentist - Periodontics
Enumeration Date: Mar 5, 2025
Last Updated: Mar 5, 2025

Practice Location

Address: 3366 PARK AVE
City: Wantagh
State: New York
ZIP Code: 11793-3770
Phone: (516) 826-4949

Authorized Official

Name: DR. JOO KIM
Title: PARTNER
Phone: (516) 826-4949

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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