Provider Demographics
NPI:1194949925
Name:TOTAL DENTAL CARE OF FARMINGVILLE, LLP
Entity type:Organization
Organization Name:TOTAL DENTAL CARE OF FARMINGVILLE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEKERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-696-0100
Mailing Address - Street 1:1025 PORTION RD STE H
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-2291
Mailing Address - Country:US
Mailing Address - Phone:631-696-0100
Mailing Address - Fax:631-696-4159
Practice Address - Street 1:1025 PORTION RD STE H
Practice Address - Street 2:
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11738-2291
Practice Address - Country:US
Practice Address - Phone:631-696-0100
Practice Address - Fax:631-696-4159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty