# CLOVE LAKES FAMILY DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oakwood Dental Arts of Clove Lakes
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639619208
- **Authorized official:** EMANUEL GRAZIANO DDS (PARTNER)
- **Authorized official phone:** (718) 873-4889

## Contact information

- **Practice address:** 1140 VICTORY BLVD, SUITE 1, STATEN ISLAND, NY 10301-3673
- **Practice address phone:** (718) 255-8995
- **Mailing address:** 1140 VICTORY BLVD, SUITE 1, STATEN ISLAND, NY 10301-3673
- **Mailing address phone:** (718) 255-8995

## Taxonomy

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

## Other

- **Enumeration date:** 03/02/2017
- **Last updated:** 03/02/2017