Organization
INTEGRATIVE DENTAL CARE P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT SIMONETTI DDS (PRESIDENT)
(631) 379-3902
Entity
Organization
Contact information
Practice address
127 W MAIN ST, EAST ISLIP, NY 11730
(631) 379-3902
Mailing address
325 LAKE AVE UNIT 748, SAINT JAMES, NY 11780-5045
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
049510
NY
Other
Enumeration date
03/17/2016
Last updated
03/22/2016
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