| Dr. Glen's Happy Teeth | |
|
120 W Park Ave Suite 301 Long Beach NY 11561-3301 | |
| (516) 431-5855 | |
| (516) 431-0728 |
| Full Name | Dr. Glen's Happy Teeth |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 120 W Park Ave, Long Beach, New York |
| Authorized Official Name and Position | Glen Shanock (OWNER) |
| Authorized Official Contact | 5164315855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Glen's Happy Teeth 120 W Park Ave Suite 301 Long Beach NY 11561-3301 Ph: (516) 431-5855 | Dr. Glen's Happy Teeth 120 W Park Ave Suite 301 Long Beach NY 11561-3301 Ph: (516) 431-5855 |
| NPI Number | 1730628884 |
|---|---|
| Provider Enumeration Date | 02/21/2017 |
| Last Update Date | 02/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730628884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 045836 (New York) | Primary |
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