# YOUR SMILE DENTAL OF RIVERHEAD

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

## Provider details

- **NPI number:** 1366979775
- **Authorized official:** VICTOR KATSMAN (OWNER)
- **Authorized official phone:** (516) 302-7372

## Contact information

- **Practice address:** 177 OLD COUNTRY RD STE 1, RIVERHEAD, NY 11901-2102
- **Practice address phone:** (631) 462-0300
- **Mailing address:** 6040 JERICHO TPKE, COMMACK, NY 11725-2806
- **Mailing address phone:** (631) 462-0300

## Taxonomy

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

## Other

- **Enumeration date:** 05/16/2017
- **Last updated:** 05/16/2017