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Organization
PORT WASHINGTON DENTAL CARE
Active
Organization
PORT WASHINGTON DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL KOKOLIS (OWNER/PRESIDENT)
(516) 944-5300
Entity
Organization
Contact information
Practice address
18 HAVEN AVENUE SUITE 200, PORT WASHINGTON, NY 11050-3643
(516) 944-5300
(516) 944-5304
Mailing address
18 HAVEN AVENUE SUITE 200, PORT WASHINGTON, NY 11050-3643
(516) 944-5300
(516) 944-5304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
049624
NY
1223G0001X
General Practice Dentistry
Primary
052953
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02299109
—
NY
Enumeration date
03/22/2010
Last updated
05/13/2025
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