Organization
NORTH FORK ORTHODONTICS, P.C.
Active
Organization
NORTH FORK ORTHODONTICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT FRIEDMAN D.D.S. (PRESIDENT)
(631) 727-4040
Entity
Organization
Contact information
Practice address
940 ROANOKE AVE, RIVERHEAD, NY 11901-2749
(631) 727-4040
Mailing address
940 ROANOKE AVE, RIVERHEAD, NY 11901-2749
(631) 727-4040
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D034366
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01076008
—
NY
Enumeration date
12/03/2006
Last updated
08/12/2008
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