# DI SMILES DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013663061
- **Authorized official:** DANIEL ILYAICH DDS (PRESIDENT)
- **Authorized official phone:** (917) 476-2772

## Contact information

- **Practice address:** 575 UNDERHILL BLVD STE 105, SYOSSET, NY 11791-3416
- **Practice address phone:** (516) 496-3880
- **Mailing address:** 575 UNDERHILL BLVD STE 105, SYOSSET, NY 11791-3416
- **Mailing address phone:** (516) 496-3880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/28/2022
- **Last updated:** 02/28/2022