Organization
ISLAND ORTHODONTIC,PLLC
Active
Organization
ISLAND ORTHODONTIC,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT FRIEDMAN DDS (MEMBER)
(631) 588-1199
Entity
Organization
Contact information
Practice address
500 PORTION RD, LAKE RONKONKOMA, NY 11779-4587
(631) 588-1199
Mailing address
500 PORTION RD, LAKE RONKONKOMA, NY 11779-4587
(631) 588-1199
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
034366
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01076008
—
NY
Enumeration date
12/03/2006
Last updated
03/31/2017
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