Organization
AIDS DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MANFREDI (DIRECTOR OF IT)
(516) 733-7003
Entity
Organization
Contact information
Practice address
333 N MAIN ST, FREEPORT, NY 11520-1231
(516) 623-4420
Mailing address
333 N MAIN ST, FREEPORT, NY 11520-1231
(516) 623-4420
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01635336
—
NY
Enumeration date
03/27/2007
Last updated
11/09/2011
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