Smiles On Broadway Dental Care, Pllc

NPI #1740319656 in Malverne, New York

Provider Information

NPI Number: 1740319656
Entity Type: Organization
Organization Name: Smiles On Broadway Dental Care, Pllc
Primary Specialty: Dentist
Enumeration Date: Mar 5, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 116 BROADWAY
City: Malverne
State: New York
ZIP Code: 11565-1635
Phone: (516) 599-0883

Authorized Official

Name: DR. DOMINIQUE LIZZIO, D.D.S.
Title: CO-PRESIDENT
Phone: (516) 599-0883

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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