Organization
HAMPTON PEDIATRIC DENTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY ELIZABETH COSENZA D.D.S. (OWNER)
(631) 287-8687
Entity
Organization
Contact information
Practice address
97 N MAIN ST, SOUTHAMPTON, NY 11968-3300
(631) 287-8687
(631) 204-1430
Mailing address
97 N MAIN ST, SOUTHAMPTON, NY 11968-3300
(631) 287-8687
(631) 204-1430
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
043391
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01476553
—
NY
Enumeration date
07/25/2011
Last updated
07/25/2011
Update your record
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