| Smiles On Broadway Dental Care, Pllc | |
|
116 Broadway Malverne NY 11565-1635 | |
| (516) 599-0883 | |
| (516) 599-0227 |
| Full Name | Smiles On Broadway Dental Care, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 116 Broadway, Malverne, New York |
| Authorized Official Name and Position | Dominique Lizzio (CO-PRESIDENT) |
| Authorized Official Contact | 5165990883 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles On Broadway Dental Care, Pllc 116 Broadway Malverne NY 11565-1635 Ph: (516) 599-0883 | Smiles On Broadway Dental Care, Pllc 116 Broadway Malverne NY 11565-1635 Ph: (516) 599-0883 |
| NPI Number | 1740319656 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740319656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 047179 (New York) | Primary |
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