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Organization
SUFFOLK DENTAL CARE, PC
Active
Organization
SUFFOLK DENTAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNY RODRIGUEZ (DIRECTOR OF OPERATIONS)
(917) 583-5457
Entity
Organization
Contact information
Practice address
3650 ROUTE 112 STE 105, CORAM, NY 11727-4131
(631) 732-3400
(631) 732-3401
Mailing address
1040 1ST AVE # 393, NEW YORK, NY 10022-2991
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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