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Organization

MODERN DENTISTRY OF LONG ISLAND

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HILSHA CARRION DMD (DENTIST)
(631) 473-0582
Entity
Organization

Contact information

Practice address
714 MAIN ST, PORT JEFFERSON, NY 11777-2223
(631) 473-0582
Mailing address
5 DOYLE CT, PORT JEFFERSON, NY 11777-1167
(631) 560-9536

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
03/13/2022
Last updated
03/13/2022
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