Organization
ROBERT TEISCH & JOSEPH A SIMONETTI AND ROBERT DOMOZYCH DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT SIMONETTI DDS (DENTIST PARTNER)
(631) 234-7979
Entity
Organization
Contact information
Practice address
127 W MAIN ST, EAST ISLIP, NY 11730-2343
(631) 277-4848
(631) 277-4849
Mailing address
127 W MAIN ST, EAST ISLIP, NY 11730-2343
(631) 277-4848
(631) 277-4849
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
50030265
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01435423
—
NY
Enumeration date
08/09/2006
Last updated
05/01/2015
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