Organization
BANANA SMILES PEDIATRIC DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAWAZ SHIHADEH DDS (PEDIATRIC DENTIST/ OWNER)
(561) 716-8623
Entity
Organization
Contact information
Practice address
5611 94TH ST STE LN, ELMHURST, NY 11373-5004
(718) 760-8700
Mailing address
11 HERKIMER ST APT 2A, BROOKLYN, NY 11216-6582
(561) 716-8623
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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