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Organization
PEDIATRIC DENTISTRY OF LONG ISLAND
Active
Organization
PEDIATRIC DENTISTRY OF LONG ISLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT LOUIS GOLDSTEIN DDS (CEO)
(631) 654-4242
Entity
Organization
Contact information
Practice address
1719 N OCEAN AVE STE C, MEDFORD, NY 11763-2669
(631) 654-4242
(631) 654-4291
Mailing address
1719 N OCEAN AVE STE C, MEDFORD, NY 11763-2669
(631) 654-4242
(631) 654-4291
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
041152
NY
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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