Organization
YOUR SMILE DENTAL OF RIVERHEAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR KATSMAN (OWNER)
(516) 302-7372
Entity
Organization
Contact information
Practice address
177 OLD COUNTRY RD STE 1, RIVERHEAD, NY 11901-2102
(631) 462-0300
Mailing address
6040 JERICHO TPKE, COMMACK, NY 11725-2806
(631) 462-0300
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/16/2017
Last updated
05/16/2017
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