Organization
DI SMILES DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ILYAICH DDS (PRESIDENT)
(917) 476-2772
Entity
Organization
Contact information
Practice address
575 UNDERHILL BLVD STE 105, SYOSSET, NY 11791-3416
(516) 496-3880
Mailing address
575 UNDERHILL BLVD STE 105, SYOSSET, NY 11791-3416
(516) 496-3880
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/28/2022
Last updated
02/28/2022
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