# FAMILY DENTIST OF GREAT NECK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Preferred Dental Care - Great Neck
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992587505
- **Authorized official:** BIBI ABRAHIM (FINANCE MANAGER)
- **Authorized official phone:** (718) 445-7600

## Contact information

- **Practice address:** 17 MAPLE DR, GREAT NECK, NY 11021-2049
- **Practice address phone:** (516) 482-2215
- **Mailing address:** 17 MAPLE DR, GREAT NECK, NY 11021-2049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |

## Other

- **Enumeration date:** 10/18/2023
- **Last updated:** 12/29/2023