# ROBERT TEISCH & JOSEPH A SIMONETTI AND ROBERT DOMOZYCH DDS PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1821008160
- **Authorized official:** DR. SCOTT SIMONETTI DDS (DENTIST PARTNER)
- **Authorized official phone:** (631) 234-7979

## Contact information

- **Practice address:** 127 W MAIN ST, EAST ISLIP, NY 11730-2343
- **Practice address phone:** (631) 277-4848
- **Practice address fax:** (631) 277-4849
- **Mailing address:** 127 W MAIN ST, EAST ISLIP, NY 11730-2343
- **Mailing address phone:** (631) 277-4848
- **Mailing address fax:** (631) 277-4849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 50030265 | NY | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 05/01/2015