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Organization
LONG ISLAND FAMILY DENTISTRY
Active
Organization
LONG ISLAND FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARA MIKHAIL (DDS, PROVIDER)
(631) 835-0569
Entity
Organization
Contact information
Practice address
26 W MERRICK RD, FREEPORT, NY 11520-3827
(631) 835-0569
Mailing address
6 LEARY LN, NESCONSET, NY 11767-1810
(631) 835-9569
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
054016
NY
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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