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Organization
SMILES ON BROADWAY DENTAL CARE, PLLC
Active
Organization
SMILES ON BROADWAY DENTAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINIQUE LIZZIO D.D.S. (CO-PRESIDENT)
(516) 599-0883
Entity
Organization
Contact information
Practice address
116 BROADWAY, MALVERNE, NY 11565-1635
(516) 599-0883
(516) 599-0227
Mailing address
116 BROADWAY, MALVERNE, NY 11565-1635
(516) 599-0883
(516) 599-0227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
047179
NY
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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