Organization
HARBORBAY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN ANTHONY GRANDILLO DDS (DENTIST)
(631) 666-0427
Entity
Organization
Contact information
Practice address
160 BRENTWOOD RD, BAY SHORE, NY 11706-6948
(631) 666-0427
(631) 647-7687
Mailing address
160 BRENTWOOD RD, BAY SHORE, NY 11706-6948
(631) 666-0427
(631) 647-7687
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
048345-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02699012
—
NY
Enumeration date
08/19/2011
Last updated
08/19/2011
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