Organization
EASTERN ISLAND DENTAL CARE PLLC
Active
Other names
Lindenhurst Village Dental
Organization subpart
No
Provider details
NPI number
Authorized official
LISA SANDMAN (DIR OF OPERATIONS)
(631) 413-2912
Entity
Organization
Contact information
Practice address
195 N WELLWOOD AVE, LINDENHURST, NY 11757-4005
(631) 226-0146
Mailing address
195 N WELLWOOD AVE, LINDENHURST, NY 11757-4005
(631) 226-0146
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03269418
—
NY
Enumeration date
11/30/2020
Last updated
11/30/2020
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