Island Orthodontic,pllc | |
500 Portion Rd Lake Ronkonkoma NY 11779-4587 | |
(631) 588-1199 | |
Not Available |
Full Name | Island Orthodontic,pllc |
---|---|
Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 500 Portion Rd, Lake Ronkonkoma, New York |
Authorized Official Name and Position | Scott Friedman (MEMBER) |
Authorized Official Contact | 6315881199 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Island Orthodontic,pllc 500 Portion Rd Lake Ronkonkoma NY 11779-4587 Ph: (631) 588-1199 | Island Orthodontic,pllc 500 Portion Rd Lake Ronkonkoma NY 11779-4587 Ph: (631) 588-1199 |
NPI Number | 1558439844 |
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Provider Enumeration Date | 12/03/2006 |
Last Update Date | 03/31/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558439844 | NPI | - | NPPES |
01076008 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 034366 (New York) | Primary |
News Archive
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Sachem Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 469 Hawkins Ave, Suite 101, Lake Ronkonkoma, NY 11779 Phone: 631-588-8280 Fax: 631-588-6258 |