| Three Village Orthodontics | |
|
2500 Nesconset Hwy Building 6-b Stony Brook NY 11790-2555 | |
| (631) 689-3131 | |
| (631) 689-3529 |
| Full Name | Three Village Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2500 Nesconset Hwy, Stony Brook, New York |
| Authorized Official Name and Position | Andrew Everett (PRESIDENT) |
| Authorized Official Contact | 6316893131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Three Village Orthodontics 2500 Nesconset Hwy Building 6-b Stony Brook NY 11790-2555 Ph: (631) 689-3131 | Three Village Orthodontics 2500 Nesconset Hwy Building 6-b Stony Brook NY 11790-2555 Ph: (631) 689-3131 |
| NPI Number | 1790149045 |
|---|---|
| Provider Enumeration Date | 04/12/2016 |
| Last Update Date | 04/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790149045 | NPI | - | NPPES |
| 00000000000000000000 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 054294 (New York) | Primary |
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