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Organization

LIS SMILE DENTAL OFFICE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ZEENA LI DDS (MANAGER)
(718) 238-4545
Entity
Organization

Contact information

Practice address
6924 13TH AVE, SUI1FLOOR, BROOKLYN, NY 11228-1624
(718) 238-4545
(718) 238-9084
Mailing address
6924 13TH AVE STE 1, BROOKLYN, NY 11228-1624
(718) 238-4545
(718) 238-9084

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
047770-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01892502
NY
Enumeration date
03/11/2008
Last updated
03/11/2008
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