Individual
DR. TARA EARLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
285 SILLS RD, EAST PATCHOGUE, NY 11772-4869
(631) 289-9000
Mailing address
5 CULVER CT, MELVILLE, NY 11747-1623
(516) 375-6387
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
061952
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2019
Last updated
09/28/2021
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