Organization
ESTHETIC SMILE DENTISTRY PLLC
Active
Other names
Molar to Molar Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAIFALI RAMETRA DDS (OWNER)
(631) 771-1577
Entity
Organization
Contact information
Practice address
554 LARKFIELD ROAD, SUITE 100, EAST NORTHPORT, NY 11731-4205
(631) 315-1020
(631) 771-1570
Mailing address
554 LARKFIELD RD STE 100, EAST NORTHPORT, NY 11731-4205
(631) 315-1020
(631) 771-1570
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
010061
CT
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05372216
—
NY
Enumeration date
05/05/2010
Last updated
06/17/2022
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