Organization
SOUTH SHORE PEDIATRIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSS E GRUBER D.D.S (OWNER)
(631) 289-9000
Entity
Organization
Contact information
Practice address
285 SILLS RD, SUITE 3B, EAST PATCHOGUE, NY 11772-4869
(631) 289-9000
(631) 289-9009
Mailing address
285 SILLS RD, SUITE 3B, EAST PATCHOGUE, NY 11772-4869
(631) 289-9000
(631) 289-9009
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
045321-1
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
048497-1
NY
Other
Enumeration date
04/19/2007
Last updated
09/11/2025
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