Organization
PEDIATRIC DENTISTRY OF LONG ISLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT LOUIS GOLDSTEIN DDS (CEO)
(631) 654-4242
Entity
Organization
Contact information
Practice address
1719 N OCEAN AVE STE C, MEDFORD, NY 11763-2669
(631) 654-4242
(631) 654-4291
Mailing address
1719 N OCEAN AVE STE C, MEDFORD, NY 11763-2669
(631) 654-4242
(631) 654-4291
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
041152
NY
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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