Organization
SUFFOLK PEDIATRIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT SERINO DDS (PRESIDENT)
(631) 928-8585
Entity
Organization
Contact information
Practice address
8 MEDICAL DRIVE, PORT JEFFERSON STATION, NY 11776
(631) 928-8585
(631) 928-8861
Mailing address
8 MEDICAL DRIVE, PORT JEFFERSON STATION, NY 11776
(631) 928-8585
(631) 928-8861
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01864713
—
NY
Enumeration date
02/05/2007
Last updated
10/05/2016
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