| NPI | 1417669052 |
|---|---|
| Doing Business As | SMILE ON WESTBURY |
| Entity Type | Organization |
| Authorized Contact | SORNANONG YAIBUATHES Dentist 631-428-4331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2022-12-14 |