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Organization
TOTAL DENTAL CARE OF MIDDLE ISLAND P.C.
Active
Organization
TOTAL DENTAL CARE OF MIDDLE ISLAND P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIZ ANN JERMYN (OFFICE MANAGER)
(631) 924-8155
Entity
Organization
Contact information
Practice address
699 MIDDLE COUNTRY RD, MIDDLE ISLAND, NY 11953-2510
(631) 924-8155
(631) 345-5611
Mailing address
699 MIDDLE COUNTRY RD, MIDDLE ISLAND, NY 11953-2510
(631) 924-8155
(631) 345-5611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0300X
Periodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
05/15/2007
Last updated
08/31/2007
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