Organization
YOUR SMILE DENTAL OF FREEPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR KATSMAN DDS (OWNER)
(631) 462-0300
Entity
Organization
Contact information
Practice address
415 W MERRICK RD, FREEPORT, NY 11520-4144
(631) 462-0300
Mailing address
6040 JERICHO TPKE, COMMACK, NY 11725-2806
(631) 462-0300
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03269418
—
NY
Enumeration date
09/28/2017
Last updated
09/28/2017
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