| NPI | 1144921602 |
|---|---|
| Doing Business As | KID SMILES PEDIATRIC DENTISTRY OF PORT JEFFERSON STATION PLLC |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LYNN PASTORE Insurance Coordinator 516-548-8753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-03-13 |